Takuro Miyazaki1, Hisashi Saji2, Hiroshige Nakamura3, Takeshi Nagayasu4, Norihito Okumura5, Masanori Tsuchida6, Makoto Sonobe7, Keiju Aokage8, Masayuki Nakao9, Tomohiro Haruki3, Morihito Okada10,11, Kenji Suzuki12,11, Masayuki Chida13, Ichiro Yoshino14. 1. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. miyataku@nagasaki-u.ac.jp. 2. Department of Chest Surgery, St. Marianna University School of Medicine, Kawasaki, Japan. 3. Department of Surgery, Division of General Thoracic Surgery, Faculty of Medicine, Tottori University, Tottori, Japan. 4. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. 5. Department of Thoracic Surgery, Kurashiki Central Hospital, Okayama, Japan. 6. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 7. Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 8. Division of Thoracic Surgery, Department of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan. 9. Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. 10. Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan. 11. Committee for Scientific Affairs, The Japanese Association for Chest Surgery, Kyoto, Japan. 12. Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan. 13. Department of General Thoracic Surgery, Dokkyo Medical University, Shimotsuga, Japan. 14. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan and President, The Japanese Association for Chest Surgery, Kyoto, Japan.
Abstract
PURPOSE: To establish the prognostic significance of C-reactive protein (CRP) and albumin in octogenarians with non-small cell lung cancer (NSCLC) based on the study of the Japanese Association for Chest Surgery (JACS 1303). METHODS: A total of 618 octogenarians with pathological stage I NSCLC, who underwent pulmonary resection, were included in the analysis. We conducted multivariable Cox regression analysis to evaluate the CRP to albumin ratio (CAR) as a potential prognostic factor. Other clinicopathological factors were also evaluated. RESULTS: The median age was 82 years. Operations included lobectomy (n = 388; 62.8%) segmentectomy (n = 95; 15%), and wedge resection (n = 135; 22%). Pathological stage IA was diagnosed in 380 (61.5%) patients. The 3-year (OS) and cancer-specific survival (CS) rates were 86.7% and 94.6%, respectively. OS was significantly higher for patients with low CAR (< 0.106) than for those with high CAR (≥ 0.106) (hazard ratio = 3.13, 95% confidence interval: 1.99-4.93, p < 0.0001). Univariate analysis identified sex, poor performance status, smoking status, comorbidity, solid tumor, histology, high Glasgow prognostic scale, and high CAR as significant prognostic factors. Multivariate analysis identified only the CAR as a significant prognostic factor for both OS and CS. CONCLUSIONS: Our analysis of the nationwide data demonstrated that the CAR is a useful prognostic factor for elderly patients with stage I NSCLC.
PURPOSE: To establish the prognostic significance of C-reactive protein (CRP) and albumin in octogenarians with non-small cell lung cancer (NSCLC) based on the study of the Japanese Association for Chest Surgery (JACS 1303). METHODS: A total of 618 octogenarians with pathological stage I NSCLC, who underwent pulmonary resection, were included in the analysis. We conducted multivariable Cox regression analysis to evaluate the CRP to albumin ratio (CAR) as a potential prognostic factor. Other clinicopathological factors were also evaluated. RESULTS: The median age was 82 years. Operations included lobectomy (n = 388; 62.8%) segmentectomy (n = 95; 15%), and wedge resection (n = 135; 22%). Pathological stage IA was diagnosed in 380 (61.5%) patients. The 3-year (OS) and cancer-specific survival (CS) rates were 86.7% and 94.6%, respectively. OS was significantly higher for patients with low CAR (< 0.106) than for those with high CAR (≥ 0.106) (hazard ratio = 3.13, 95% confidence interval: 1.99-4.93, p < 0.0001). Univariate analysis identified sex, poor performance status, smoking status, comorbidity, solid tumor, histology, high Glasgow prognostic scale, and high CAR as significant prognostic factors. Multivariate analysis identified only the CAR as a significant prognostic factor for both OS and CS. CONCLUSIONS: Our analysis of the nationwide data demonstrated that the CAR is a useful prognostic factor for elderly patients with stage I NSCLC.
Authors: M J Proctor; D S Morrison; D Talwar; S M Balmer; D S J O'Reilly; A K Foulis; P G Horgan; D C McMillan Journal: Br J Cancer Date: 2011-01-25 Impact factor: 7.640