Table of Contents
ISRN Surgery
Volume 2013 (2013), Article ID 175304, 7 pages
http://dx.doi.org/10.1155/2013/175304
Clinical Study

Completely Resected N0 Non-Small Cell Lung Cancer: Prognostic Factors Affecting Long-Term Survival

1General Thoracic Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai 50200, Thailand
2Department of Pathology, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai 50200, Thailand
3Cardiovascular Thoracic Unit, Department of Surgery, Lampang Hospital, Lampang 52000, Thailand
4Cardiovascular Thoracic Unit, Department of Surgery, Chest Institute, Nonthaburi 11000, Thailand
5Department of Community Medicine, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai 50200, Thailand

Received 27 June 2013; Accepted 1 August 2013

Academic Editors: D. Laub, A. Petroianu, and J. P. Wei

Copyright © 2013 Apichat Tantraworasin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Although early stage non-small cell lung cancer (NSCLC) has an excellent outcome and correlated with good long-term survival, up to 15 percent of patients still relapse postoperatively and die. This study is conducted to identify prognostic factors that may affect the long-term survival in completely resected N0 NSCLC. Methods. Medical records of 124 patients with completely resected N0 NSCLC were retrospectively reviewed. Prognostic factors affecting long-term survival were analyzed by the Kaplan-Meier method and Cox proportional hazards analysis. Results. Overall five-year survival rate was 48 percent. Multivariable analysis revealed stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases as significant prognostic factors affecting long-term survival. The hazard ratio (HR) of tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases was 2.0, 2.3, 7.6, 4.1, and 8.3, respectively, and all P values were less than 0.001. Conclusions. Our study shows stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastasis, and skin metastasis as the independent prognostic factors of long-term survival in pathological N0 NSCLC. Early stage NSCLC patients without nodal involvement or presented with tumor necrosis should benefit from adjuvant chemotherapy, and sites of metastasis could predict the long-term survival as described.