Research Of Prognostic Factors Of Recurrence-free Survival And Associated Factors Of Predicting The Recurrence-free Interval In Stage Ⅰ Non Small Cell Lung Cancer

Background and objectivelung cancer is the leading cause of death caused by tumor in the world.The recurrence rate of Stage I NSCLC after surgical removal range from 27% to 38%.There have been a lot of literature researched risk factors of overall survival and no-recurrence survival in stage I NSCLC, but no literature studied the influence factors of the recurrence-free interval, especially about the early recurrence and the late recurrence.The purpose of this study is to find out the the influence factors of recurrence-free survival time interval in stage I NSCLC, setting up a model which can predict the recurrence time of the patients.Materials and methodsThe study retrospectively collected 144 cases of stage I NSCLC treated with surgery from January 2004 to December 2013 in Qilu hospital of Shandong University and retrospectively analyses the general clinical characteristics, surgical pathology characteristics and serological related factors.Using Kaplan-Meier curves and the Log-rank test comparing survival rate differences,and using the proportional hazards model (Cox model) for multiple factors analysis. The single factor analysis of hierarchical classification variables were respectively used by the Mann-Whitney U test and Kruskal-Wallis H test. At the last, logistic regression analysis was adopted to establish the recurrence time prediction model.Results(1)144 stage I NSCLC patients into the study, including 45 cases with recurrence, the recurrence rate was 31.25%.(2)Tumor recurrence type was independent prognostic factor for overall survival.local recurrence (HR=13.826; 95% CI,3.718 51.408; p=.001) and distant metastasis (HR =16.814; 95% CI,3.718 51.408; p=.000) had poorer OS prognosis. Initial symptoms without hemoptysis (HR=.209; 95% CI, the 069-630; p=.005), no chest humeral back pain (HR=.373; 95% CI, the 155-899; p=.028), cleaning the lymph node number> 11 (HR=.358; 95% CI,.174--.734; p=.005), preoperative NEU/LYM count ratio> 2.67 (HR= 2.255; 95% CI,1.211-4.196; p=.010), postoperative ESO percentage> 0.2%(HR= 2.284; 95% CI,1.215-4.294; p=.010) are independent predictors of tumor recurrence.3.144 patients with RFI RFI<12 months,12<RFI<24 months and RFI> 24 months account for 11.1%,9.0% and 79.9% respectively. The study established the probability model of RFI in different time according to the results of logistic regression, which indicating predictors of early relapse were:initial symptom of cough and expectoration, hemoptysis, chest humeral back pain, tumor diameter> 3 cm, and no postoperative adjuvant therapy.Conclusion(1) Initial symptoms without hemoptysis, chest humeral back pain, cleaning the lymph node number> 11, preoperative NEU/LYM count ratio> 2.67, postoperative ESO percentage> 0.2% were independent predictors of recurrence of stage I NSCLC.(2) Patients with initial symptoms of cough and expectoration, hemoptysis, chest humeral back pain, tumor length to diameter> 3 cm, and postoperative adjuvant therapy had a short recurrence interval. These are the early predictors of recurrence of stage I NSCLC.