ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Robert J. Cerfolio
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Cerfolio, R. J.
Right arrow Articles by Bryant, A. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cerfolio, R. J.
Right arrow Articles by Bryant, A. S.
Related Collections
Right arrow Lung - cancer

Ann Thorac Surg 2007;84:182-190
© 2007 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Predictors of Survival and Disease-Free Survival in Patients With Resected N1 Non-Small Cell Lung Cancer

Robert J. Cerfolio, MDa,*, Ayesha S. Bryant, MDb

a Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
b Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama

Accepted for publication March 12, 2007.

* Address correspondence to Dr Cerfolio, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, 1900 University Blvd., THT 712, Birmingham, AL 35294 (Email: rcerfolio{at}uab.edu).

Presented at the Forty-third Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 29–31, 2007.

Background: Factors that predict poor survival or increased risk of recurrence for patients with N1 disease may be dependent on tumor characteristics.

Methods: This study was a retrospective review of a prospective database of consecutive patients who had clinical or pathologic N1 non-small cell lung cancer (NSCLC) who underwent preoperative 2-[(18)F] fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) scans and complete resection with thoracic lymphadenectomy.

Results: There were 135 patients (88 men). The 5-year disease-free rate was 55%. Kaplan-Meier analysis showed that poor differentiation (p = 0.036), multiple N1 stations (p = 0.010), and the lack of adjuvant chemotherapy (p = 0.039) were all associated with a shorter 5-year disease-free rate. Multivariate disease-free analysis demonstrated that only multiple stations (p = 0.002) were independently associated with recurrence. The overall 5-year survival was 48%. Univariate analysis showed that multiple nodes within one station (p = 0.016), multiple station involvement (p = 0.041), and lack of adjuvant chemotherapy (p = 0.039) and moderate-to-poor tumor differentiation (p = 0.046) were associated with decreased survival. Multivariate analysis found that multiple stations, multiple nodes, and lack of adjuvant chemotherapy were independent predictors of poor survival. Integrated PET-computed tomography (CT) was significantly more sensitive for staging N1 disease than dedicated FDG-PET (p = 0.032). Neoadjuvant chemotherapy given to 48 nonrandomized patients did not seem to impact disease recurrence or overall 5-year survival rates (p = 0.349).

Conclusions: Factors that predict a poor outcome in patients with resected N1 NSCLC are the involvement of multiple N1 stations, multiple N1 nodes, and the lack of adjuvant chemotherapy. Integrated PET-CT is more sensitive for detecting N1 disease then dedicated PET. These data may influence preoperative or postoperative therapy, or both.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 by The Society of Thoracic Surgeons.