Prognosis Analysis Of471Cases Stage Ⅰ Non-small Cell Lung Cancer

Background and Objective: Lung cancer is a major health problem in the world.The morbidity and mortality is increasing year by year. According to the statistics of theUnited States, The cases of lung cancer are221130in2011, and the deaths of lungcancer is106070. Lung cancer is the first fatal reason of malignant tumor. So theresearch for lung cancer has also been in-depth to carry out. The announced new TNMstaging system of Lung cancer, in2009, put forward the importance of maximum tumordiameter about the prognostic of non-small cell lung cancer. This project aims toexplore the prognostic factors in clinical stage I NSCLC patients, to improve thestandard treatment and long-term efficacy of lung cancer, and to be able to verify thatthe new version of the staging guidance the clinical significancy for the stage Inon-small cell lung cancer.Methods: Single-center retrospective study of471cases suffered from stage I non-small cell lung cancer who get the complete resection by Thoracic Surgery of the FirstAffiliated Hospital of Dalian Medical University from June2004to December2010.Follow-up survival data received by telephone and outpatient. Survival and disease-freetime calculated by day and exclusion of those who died of other diseases. Multipleitems that were selected from clinical data and follow-up data from patients used in thisstudy include:age, sex, surgery, pathological classification, degree of differentiation,tumor size, T stage, tumor stage, and visceral pleura violation9lung cancer prognosticfactors, quantitative assignment of the observed indicators. All the factors were enteredinto the computer to do a retrospective clinical analysis by statistical software SPSS18.0statistical analysis: calculating1year,3-year,5-year survival rate with the life tablemethod, single-factor analysising with the Kaplan-Meier method (product-limitmethod), and comparing different survival probability after each variable stratified with the Log-rank test (each variable stratified log-rank test). Cox regression model of P<0.05possible factors that associated with the probability of survival will be included inthe multivariate analysis (proportional hazards regression model). On account of themaximum tumor diameter for different levels of tumor, use the above statistical methodto analyze the influence of visceral pleura infringement on the prognosis.Result:1-year,3-year,5-year survival of471stage I non-small cell lung cancerpatients were90%,75%,67%; and the disease-free survival were86%、71%and59%.Univariate analysis showed: age(P=0.002), gender(P<0.001), histological classification(P=0.011), tumor longest diameter(P<0.001), T stage(P<0.001), TNM stage(P=0.008)and degree of differentiation(P<0.001) had relationship with long-term survival. Theoperation(P=0.199) and visceral pleura infringement(P=0.141) had on relationship withlong-term survival. Multivariate analysis showed: age(P=0.005), maximum tumordiameter(P<0.05) and degree of differentiation(P<0.001) were independent prognosticfactors for prognosis. In disease-free survival, maximum tumor diameter(P<0.001) anddegree of differentiation(P<0.001) had statistically significant for disease-free survival.In stage I non-small cell lung cancer of maximum tumor diameter≤2.0cm(P=0.756) and2cm<maximum tumor diameter≤3cm(P=0.985), visceral pleura infringement had nostatistically significant. In stage I non-small cell lung cancer of3cm<maximum tumordiameter≤5cm, visceral pleura infringement had statistically significant (P=0.026).Multivariate analysis showed that visceral pleura infringement(P=0.006) and lowdifferentiation(P<0.001) were independent prognostic factors for prognosis.Conclusion: The maximum tumor diameter, and tumor differentiation wereindependent risk factors for prognostic in non-small cell lung cancer of stage I. Invadesvisceral pleura and low differentiation were independent risk factors for prognostic instage Ib non-small cell lung cancer which maximum tumor diameter was between3cmand5cm.7th edition of the non-small cell lung cancer TNM staging had a clinicalsignificance.