Prognostic factors of tumor recurrence in completely resected non-small cell lung cancer

Figures & data

Table 1 Patient characteristic between two groups

Characteristics	Nonrecurrence (n = 107)	Recurrence (n = 120)	P-value
Age, mean ± SD	61.4 ± 10.5	62.8 ± 10.5	0.322
Male, n (%)	64 (59.8)	69 (57.5)	0.788
Smoking			0.820
Never smoked	30 (28.0)	30 (25.0)
Stopped smoking	71 (66.4)	80 (66.7)
Active smoker	5 (4.7)	7 (5.8)
Passive smoker	1 (0.9)	3 (2.5)
Packs per year, mean ± SD	19.1 ± 16.9	19.1 ± 17.7	0.863
Family history of malignancy	7 (6.5)	5 (4.2)	0.555
Underlying disease
Chronic lung disease	14 (13.1)	15 (12.5)	1.000
Diabetic mellitus	12 (11.2)	15 (12.5)	0.839
Essential hypertension	34 (31.8)	43 (35.8)	0.575
Dyslipidemia	18 (16.8)	15 (12.5)	0.451
Symptoms
Hemoptysis	48 (44.9)	48 (40.0)	0.502
Chronic cough	48 (44.9)	52 (43.3)	0.894
Poor appetite	16 (15.0)	15 (12.5)	0.699
Significant weight loss	33 (30.8)	30 (25.0)	0.374
Chest pain	9 (8.4)	11 (9.2)	1.000
Dyspnea	17 (15.9)	25 (20.8)	0.393
Asymptomatic	38 (35.5)	43 (35.8)	1.000

Abbreviation: SD, standard deviation.

Table 2 Treatment modalities

Procedure and chemotherapy	Nonrecurrence (n = 107)	Recurrence (n = 120)	P-value
Surgical procedures			0.419
Lobectomy	89 (83.2)	108 (90.0)
Bilobectomy (RUL and RML)	3 (2.8)	3 (2.5)
Bilobectomy (RLL and RML)	12 (11.2)	8 (6.7)
Pneumonectomy	3 (2.8)	1 (0.8)
Chemotherapy			0.103
No chemotherapy	63 (58.9)	54 (45.0)
Adjuvant chemotherapy	42 (39.3)	62 (51.7)
Neoadjuvant chemotherapy	2 (1.9)	4 (3.3)

Abbreviations: RLL, right lower lobe; RML, right middle lobe; RUL, right upper lobe.

Table 3 Histopathologic reports

Covariates	Nonrecurrence (n = 107)	Recurrence (n = 120)	P-value
Histologic types			0.848
Adenocarcinoma	61 (57.0)	72 (60.0)
Squamous cell carcinoma	29 (27.1)	32 (26.7)
Others*	17 (15.9)	16 (13.3)
Tumor grading			0.644
Well differentiated	34 (31.8)	48 (40.0)
Moderately differentiated	45 (42.1)	44 (36.7)
Poorly differentiated	18 (16.8)	22 (18.3)
Undifferentiated	4 (3.7)	3 (2.5)
Mucinous type of adenocarcinoma in situ	3 (2.8)	2 (1.7)
Nonmucinous type of adenocarcinoma in situ	3 (2.8)	1 (0.8)
Pathological staging			0.041
IA	20 (18.7)	13 (10.8)
IB	25 (23.4)	21 (17.5)
IIA	17 (15.9)	21 (17.5)
IIB	19 (17.8)	12 (10.0)
IIIA	24 (23.4)	51 (42.5)
IIIB	1 (0.9)	2 (1.7)
Tumor diameter (cm)			0.325
≤5	75 (70.1)	76 (63.3)
>5	32 (29.9)	44 (36.7)
Nodal involvement			0.003
Nodal negative	72 (67.3)	57 (47.5)
Nodal positive#	35 (32.7)	63 (52.5)
Tumor necrosis	36 (33.6)	56 (46.7)	0.058
Visceral pleural invasion	19 (17.8)	29 (24.2)	0.258
Neural invasion	3 (2.8)	6 (5.0)	0.506
Intratumoral lymphatic invasion	84 (78.5)	104 (86.7)	0.115
Intratumoral blood vessel invasion	32 (29.9)	64 (53.3)	<0.001

Notes:

* Other cell types include adenocarcinoma in situ,²⁴ large cell carcinoma, neuroendocrine tumor, adenoid cystic carcinoma, metastasis, mucoepidermoid carcinoma, lymphoepithelioma-like carcinoma, adenosquamous cell carcinoma;

# nodal positive refers to the presence of malignant cells, in any node level (1–14).

Table 4 Sites of metastases

Sites	Number of patients	%
Lung	59	49.1
Brain	31	25.8
Bone	17	14.2
Liver	6	5.0
Supraclavicular lymph node	5	4.2
Skin	5	4.2
Adrenal gland	4	3.3
Pleura	4	3.3
Mediastinal lymph node	3	2.5
Chest wall	2	1.7
Kidney	1	0.8
Cervical lymph node	1	0.8
Stomach	1	0.8

Table 5 Multivariable Cox regression analysis stratified by tumor staging, chemotherapy treatment, and nodal involvement

Covariates	Hazard ratio	95% confidence interval	P-value
Age	1.0	0.9–1.0	0.556
Male	1.0	0.7–1.5	0.837
Tumor necrosis	2.1	1.3–3.4	0.001
Intratumoral blood vessel invasion	2.1	1.4–3.2	0.001
Intratumoral lymphatic invasion	1.0	0.5–1.7	0.825
Tumor diameter >5 cm	1.9	1.0–3.5	0.033

Figure 1 Recurrent-free survival curves by tumor necrosis.

Abbreviation: TN, tumor necrosis.

Figure 2 Recurrent-free survival curves by intratumoral blood vessel invasion (IVI).

Figure 3 Recurrent-free survival curves by tumor size.

Abbreviation: T, maximal tumor diameter (cm)

TravisWDBrambillaENoguchiMInternational association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinomaJ Thorac Oncol20116224428521252716

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