Analysis Of Prognostic Factors For Patients With Stage Ⅰ Non-small Cell Lung Cancer After Operation

Objectives: 1. To explore the prognostic factors for patients with stage I non-small cell lung cancer(NSCLC) after operation. 2. To explore the indications of chemotherapy for stage Ⅰ non-small cell lung cancer(NSCLC) after surgery.Methods: To collect the patients with NSCLC who had surgery in Tianjin Chest Hospital during January in 2008 to December in 2012.According to the 7th edition of TNM staging standard, selecting the patients who had no chemoradiotherapy and postoperative pathological stage forⅠ. Pathological type of the patients were adenocarcinoma, squamous carcinoma,adenosquamous carcinoma and they had a clear differentiated degree. We made a univariate and multivariate survival analysis for the patients with the method of Kaplan-Meier and COX.Variables in the analysis included age, gender, adjuvant chemotherapy, tumor size, tumor location, tumor differentiation, tumor histological type, lymphovascular invasion and visceral pleural invasion.Result:(1) The univariate and multivariate survival analysis showed that only the tumor differentiation can produce significant differences to the disease free survival and overall survival for patients with stage IA NSCLC after operation(P<0.05). The age, gender, adjuvant chemotherapy, tumor size, tumor location, lymphovascular invasion, tumor histological type cannot produce significant differences to the disease free survival and overall survival for patients with stage IA NSCLC after operation(P>0.05).(2) The univariate survival analysis showed that the tumor differentiation, lymphovascular invasion and adjuvant chemotherapy can produce significant differences to the disease free survival and overall survival for patients with stage IB NSCLC after operation(P<0.05). The age, gender, tumor size, tumor location, tumor histological type and visceral pleural invasion cannot produce significant differences to the disease free survival and overall survival for patients with stage IB NSCLC after operation(P>0.05). The multivariate survival analysis showed that only the tumor differentiation and lymphovascular invasion can produce significant differences to the disease free survival and overall survival for patients with stage IB NSCLC after operation(P<0.05). The age, gender, tumor size, tumor location, adjuvant chemotherapy, tumor histological type and visceral pleural invasion cannot produce significant differences in the disease free survival and overall survival for patients with stage IB NSCLC after operation(P>0.05).Conclusion(1) The poorly differentiated tumor is a risk factor for the prognosis of patients with stage IA NSCLC after operation, but those patients with poorly differentiated tumor should not receive adjuvant chemotherapy.(2) The poorly differentiated tumor and lymphovascular invasion are risk factors for the prognosis of patients with stage IB NSCLC after operation, those patients with poorly differentiated tumor and lymphovascular invasion should receive adjuvant chemotherapy.