Fumihiro Shoji1, Koji Yamazaki2, Hidenori Kouso2, Ryo Mori2, Sadanori Takeo2. 1. Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. Electronic address: fshoji@surg2.med.kyushu-u.ac.jp. 2. Department of Thoracic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Abstract
BACKGROUND: Although stage IA non-small cell lung cancer has an optimistic survival rate, up to 10% of these patients relapse after surgical procedures and die. We retrospectively analyzed clinicopathologic features of patients with stage IA non-small cell lung cancer to identify recurrence predictors and to investigate effects of preoperative serum Krebs von den Lungen-6 (PS-KL-6) concentrations. METHODS: We selected 204 consecutive patients with stage IA non-small cell lung cancer treated from December 2003 to December 2009 for this study and tested their PS-KL-6 concentrations in univariate and multivariate Cox regression analyses of recurrence-free survival (RFS). RESULTS: High PS-KL-6 concentration (PS-KL6(High)) was significantly associated with sex (p = 0.0006), smoking status (p = 0.0438), histology (p = 0.0049), and postoperative recurrence (p = 0.0058). Both intratumoral blood vessel invasion (p = 0.0345) and PS-KL6(High) (p = 0.0021) were identified as independent predictors of shorter RFS. Relative risk of patients with PS-KL6(High) was 3.478 compared with patients with low PS-KL-6 concentration (PS-KL6(Low); 95% confidence interval: 1.576 to 8.013). Among patients with tumors larger than 2 cm (T1b), the PS-KL6(High) group had significantly shorter RFS than the PS-KL6(Low) group (p = 0.0040). CONCLUSIONS: PS-KL-6 concentration is a simple and novel predictor of recurrence in patients with stage IA non-small cell lung cancer and might help to identify patients who will need more careful follow-up among T1bN0M0 series.
BACKGROUND: Although stage IA non-small cell lung cancer has an optimistic survival rate, up to 10% of these patients relapse after surgical procedures and die. We retrospectively analyzed clinicopathologic features of patients with stage IA non-small cell lung cancer to identify recurrence predictors and to investigate effects of preoperative serum Krebs von den Lungen-6 (PS-KL-6) concentrations. METHODS: We selected 204 consecutive patients with stage IA non-small cell lung cancer treated from December 2003 to December 2009 for this study and tested their PS-KL-6 concentrations in univariate and multivariate Cox regression analyses of recurrence-free survival (RFS). RESULTS: High PS-KL-6 concentration (PS-KL6(High)) was significantly associated with sex (p = 0.0006), smoking status (p = 0.0438), histology (p = 0.0049), and postoperative recurrence (p = 0.0058). Both intratumoral blood vessel invasion (p = 0.0345) and PS-KL6(High) (p = 0.0021) were identified as independent predictors of shorter RFS. Relative risk of patients with PS-KL6(High) was 3.478 compared with patients with low PS-KL-6 concentration (PS-KL6(Low); 95% confidence interval: 1.576 to 8.013). Among patients with tumors larger than 2 cm (T1b), the PS-KL6(High) group had significantly shorter RFS than the PS-KL6(Low) group (p = 0.0040). CONCLUSIONS:PS-KL-6 concentration is a simple and novel predictor of recurrence in patients with stage IA non-small cell lung cancer and might help to identify patients who will need more careful follow-up among T1bN0M0 series.