Prognostic Factors for Lymph Node Negative Stage I and IIA Non-small Cell Lung Cancer: Multicenter Experiences

Background: Surgery is the only curative treatment for operable non-small lung cancer (NSCLC) and theimportance of adjuvant chemotherapy for stage IB patients is unclear. Herein, we evaluated prognostic factorsfor survival and factors related with adjuvant treatment decisions for stage I and IIA NSCLC patients withoutlymph node metastasis. Materials and
Methods: We retrospectively analyzed 302 patients who had undergonecurative surgery for prognostic factors regarding survival and clinicopathological factors related to adjuvantchemotherapy.
Results: Nearly 90% of the patients underwent lobectomy or pneumonectomy with mediastinallymph node resection. For the others, wedge resection were performed. The patients were diagnosed as stageIA in 35%, IB in 49% and IIA in 17%. Histopathological type (p=0.02), tumor diameter (p=0.01) and stage(p<0.001) were found to be related to adjuvant chemotherapy decisions, while operation type, lypmhovascularinvasion (LVI), grade and the presence of recurrence were important factors in predicting overall survival (OS),and operation type, tumor size greater than 4 cm, T stage, LVI, and visceral pleural invasion were related withdisease free survival (DFS). Multivariate analysis showed operation type (p<0.001, hazard ratio (HR):1.91) andthe presence of recurrence (p<0.001, HR:0.007) were independent prognostic factors for OS, as well visceralpleural invasion (p=0.01, HR:0.57) and LVI (p=0.004, HR:0.57) for DFS.
Conclusions: Although adjuvantchemotherapy is standard for early stage lymph node positive NSCLC, it has less clear importance in stage Iand IIA patients without lymph node metastasis.