Hee Chul Yang1, Hyeong Ryul Kim2, Sanghoon Jheon3, Kwhanmien Kim1, Sukki Cho1, Soyeon Ahn4, Ho-Young Lee5, Jin-Haeng Chung6, Kyung Young Chung7, Mi Kyung Bae7, Seong Yong Park7, Dong Kwan Kim2, Se Hoon Choi2, Jae Ill Zo8, Moon Soo Kim8, Jong Mog Lee8, Jhingook Kim9, Young Mog Shim9, Kook Joo Na10, Ju Sik Yun10, Jae Yong Park11. 1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea. 2. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, South Korea. 3. Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea. jheon@snu.ac.kr. 4. Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea. 5. Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea. 6. Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea. 7. Department of Thoracic and Cardiovascular Surgery, Yonsei University, College of Medicine, Seoul, South Korea. 8. Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, South Korea. 9. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 10. Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Hwasun, South Korea. 11. Lung Cancer Center, Kyungpook National University Medical Center, Daegu, South Korea.
Abstract
PURPOSE: The aim of this retrospective, multicenter study was to develop a recurrence risk-scoring model in patients with curatively resected stage I lung adenocarcinoma (ADC). METHODS: Clinicopathologic and outcome data for a development cohort of 1,700 patients with pathologic stage I ADC from four institutions resected between January 2000 and December 2009 were evaluated. A phantom study was performed for correction of inter-institutional differences in positron emission tomography-standardized uptake value (PET-SUV). A nomogram for recurrence prediction was developed using Cox proportional hazards regression. This model was validated in a cohort of 460 patients in two other hospitals. The recurrence rate was 21.0 % for the development cohort and 22.1 % for the validation cohort. RESULTS: In multivariable analysis, three independent predictors for recurrence were identified: pathologic tumor size (hazard ratio [HR] 1.03, 95 % CI 1.017-1.048; p < 0.001), corrected PET-SUV (HR 1.08, 95 % CI 1.051-1.105; p < 0.001), and lymphovascular invasion (HR 1.65, 95 % CI 1.17-2.33; p = 0.004). The nomogram was made based on these factors and a calculated risk score was accorded to each patient. Kaplan-Meier analysis of the development cohort showed a 5-year recurrence-free survival (RFS) of 83 % (95 % CI 0.80-0.86) in low-risk patients and 59 % (95 % CI 0.54-0.66) in high-risk patients with the highest 30 percentile scores. The concordance index was 0.632 by external validation. CONCLUSIONS: This recurrence risk-scoring model can be used to predict the RFS for pathologic stage I ADC patients using the above three easily measurable factors. High-risk patients need close follow-up and can be candidates for adjuvant chemotherapy.
PURPOSE: The aim of this retrospective, multicenter study was to develop a recurrence risk-scoring model in patients with curatively resected stage I lung adenocarcinoma (ADC). METHODS: Clinicopathologic and outcome data for a development cohort of 1,700 patients with pathologic stage I ADC from four institutions resected between January 2000 and December 2009 were evaluated. A phantom study was performed for correction of inter-institutional differences in positron emission tomography-standardized uptake value (PET-SUV). A nomogram for recurrence prediction was developed using Cox proportional hazards regression. This model was validated in a cohort of 460 patients in two other hospitals. The recurrence rate was 21.0 % for the development cohort and 22.1 % for the validation cohort. RESULTS: In multivariable analysis, three independent predictors for recurrence were identified: pathologic tumor size (hazard ratio [HR] 1.03, 95 % CI 1.017-1.048; p < 0.001), corrected PET-SUV (HR 1.08, 95 % CI 1.051-1.105; p < 0.001), and lymphovascular invasion (HR 1.65, 95 % CI 1.17-2.33; p = 0.004). The nomogram was made based on these factors and a calculated risk score was accorded to each patient. Kaplan-Meier analysis of the development cohort showed a 5-year recurrence-free survival (RFS) of 83 % (95 % CI 0.80-0.86) in low-risk patients and 59 % (95 % CI 0.54-0.66) in high-risk patients with the highest 30 percentile scores. The concordance index was 0.632 by external validation. CONCLUSIONS: This recurrence risk-scoring model can be used to predict the RFS for pathologic stage I ADC patients using the above three easily measurable factors. High-risk patients need close follow-up and can be candidates for adjuvant chemotherapy.
Authors: Whitney S Brandt; Ilies Bouabdallah; Kay See Tan; Bernard J Park; Prasad S Adusumilli; Daniela Molena; Manjit S Bains; James Huang; James M Isbell; Matthew J Bott; David R Jones Journal: J Thorac Cardiovasc Surg Date: 2017-11-13 Impact factor: 5.209
Authors: Lu Yang; Chong Pang; Fei Xu; Guangjian Yang; Haiyan Xu; Changli Wang; Yan Wang Journal: Cancer Manag Res Date: 2020-12-07 Impact factor: 3.989
Authors: Hyun Jung Koo; Hai Xu; Chang-Min Choi; Joon Seon Song; Hyeong Ryul Kim; Jung Bok Lee; Mi Young Kim Journal: Medicine (Baltimore) Date: 2016-01 Impact factor: 1.817