| Objective: To study the effect of postoperative adjuvant chemotherapy for 5-year disease free survival rate,the correlation of clinical pathological characteristics and 5-year disease free survival rate and the influence of postoperative adjuvant chemotherapy for 5-year disease free survival rate in patients who have related independent factors adopting the method of retrospective case analysis among stage IB non-small cell lung cancer patients with high-risk factors.The object of this is to provide the basis for the treatment strategies of stage IB non-small-cell lung cancer.Materials and Methods: Collect patients who underwent lung resection and lymph node dissection in the First Affiliated Hospital of Dalian Medical University from January 2008 to January 2012 through the system of Lian Zhong which is a digital software for medical record browsing.According to the criteria of selection and exclusion,the patients of stage IB non-small cell lung cancer who are eligible and have cases of complete information are 63.Record the clinical pathological characteristics: gender,age,histology,the degree of differentiation,the largest diameter of tumor,visceral pleural which was involved or not,vascular invaded or not,wedge resection done or not,postoperative adjuvant chemotherapy which was underwent or not,chemotherapy regimens and the cycles of chemotherapy.Follow-up of all patients had been regularly updated by consulting electronic medical records and telephoning.If patients had any symptoms or signs of recurrence additional imaging studies were performed regardless of the follow-up schedule.The follow-up was stopped on January 1,2017.All analyses were carried out with SPSS version 19.0.?2 test was used in the difference of clinical and pathological features between the patients which received adjuvant chemotherapy and the patients which did not.For univariate analysis of the prognosis,Kaplan-Meir method was used and survival curves were generated by it.Log-rank test was performed to establish the statistical significance.Multivariate analysis was carried out using the Cox proportional hazard model which resulted in the independent factors for 5-year disease free survival rate of stage IB non-small-cell lung cancer.Log-rank test was employed when exploring the effect of adjuvant chemotherapy for patients who had the independent prognosis factors.Statistical significance was defined at p <0.05.Results:1.Twenty patients relapsed or metastasized among all patients up to the January 1,2017.The 5-year disease-free survival rate of were 66.3%.2.In univariate analysis,the following variables were significantly associated with 5-year disease-free survival rate: postoperative adjuvant chemotherapy which was underwent or not(p =0.012),the degree of differentiation(p =0.043),vascular invaded or not(p =0.039),wedge resection done or not(p =0.016).but gender,age,histology,the largest diameter of tumor,visceral pleural which was involved or not were the factors which had no significant effect on 5-year disease-free survival rate.3.In multivariate analysis,postoperative adjuvant chemotherapy which was underwent or not(p =0.015),the degree of differentiation(p =0.037),visceral pleural which was involved or not,vascular invaded or not(p =0.044)were independent prognostic factors for the 5-year diease-free survival rate.4.The outcome of stratification analysis was that the 5-year disease-free survival rate was longer in the sick who received adjuvant chemotherapy than who did not among the patients with visceral pleural involvement(p=0.008)or vascular invasion(p =0.030);however,to the patients with poor differentiation degree,the 5-year disease-free survival rate did not have statistically significance regardless of the adjuvant chemotherapy or not.Conclusions:1.It may delay the disease recurrence to undergo postoperative adjuvant chemotherapy for the patients with visceral pleural involvement or vascular invasion;2.The postoperative adjuvant chemotherapy may be the independent factor of 5-year disease-free survival rate for stage IB non-small-cell lung cancer patients with high-risk factors. |
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