Prognostic factors in patients with resected stage I non-small cell lung cancer. A report from the Lung Cancer Study Group

Mitchell H. Gail(National Cancer Institute), Robert T. Eagan(Mayo Clinic), Ronald Feld, Robert J. Ginsberg(Toronto General Hospital), Brian W. Goodell(Fred Hutch Cancer Center), Lucius D. Hill(Swedish Medical Center), E. Carmack Holmes(University of California, Los Angeles), John M. Lukeman(The University of Texas System), Clifton F. Mountain(The University of Texas System), Robert K. Oldham(Vanderbilt University), F.G. Pearson(Toronto General Hospital), Peter Wright(Swedish Medical Center), W.H. Lake(Information Management Services), The Lung Cancer Study Group(European Organisation for Research and Treatment of Cancer)
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Abstract

The authors present prognostic information on recurrence and survival for resected Stage I lung cancer patients with squamous cell carcinoma, adenocarcinoma or large cell carcinoma. The data derive from 392 carefully staged patients and include results from the history and physical examination, preoperative laboratory tests, nature of the surgery, complications, initial pathologic findings following surgical resection, and final pathologic review. A simple multivariate model of recurrence, which is used to classify patients into low, intermediate, and high-risk groups, is based on tumor size and location (T1, T2), histologic type (squamous, nonsquamous/mixed) and nodal status (N0, N1). To model survival, the performance status and the presence of empyema, pneumonia, or wound infection were added to the previous factors. Not all factors associated with increased mortality are associated with increased risk of recurrence, and, in particular, postoperative empyema, pneumonia or wound infections carry an increased risk of death only. Serial measurements of performance status and leukocyte count have the potential for monitoring for increased risk of recurrence and death.


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