Clnicopathological Factoes Influencing Recurrence And Metastasis In Resceted Stage IB Nsclc

Background: The prognosis of resected IB non-small cell lung cancer is still not ideal,and the administration of adjuvant chemotherapy is controversial.This study aims to investigate the prognostic value of clinicopathological factors and effect of adjuvant chemotherapy(ACT)in patients with resected IB non-small cell lung cancer.Methods: Patients with stage IB lung adenocarcinoma who received curative surgical resection from 2014 to 2016 in our institution were included.The outcome of interests was recurrence-free survival(RFS).The effect clinicopathological factors on recurrence and metastasis were evaluated by Kaplan-Meier estimates and Cox regression analysis.Results: A total of 191 patients with stage IB lung adenocarcinoma,including 92 male and 99 females were identified.After a median follow-up of 50.8 months,48(25.1%)patients developed recurrence.Univariate analysis showed that gender,smoking status,diabetes mellitus,and solid/micropapillary components were associated with decreased RFS.Multivariate analysis revealed that diabetes mellitus and solid/micropapillary components were independent risk factors for poor RFS(diabetes mellitus: HR 2.488,95%CI 1.105-5.604,p=0.028;solid/micropapillary: HR,3.115,95%CI 1.727-5.639,p<0.001).Multivariate analysis including ACT and surgical methods consistently verified the deterioration effect of diabetes mellitus and solid/micropapillary,it also indicated that ACT failed to show benefit on RFS(HR,0.817,95%CI 0.442-1.509,p=0.518).Conclusion: Solid or micropapillary component and diabetes mellitus are associated with poor prognosis in patients with resected IB lung adenocarcinoma,and adjuvant chemotherapy fails to improve the prognosis.