Prognosis of Patients with Non-Small Cell Lung Cancer after Surgery

Kang, Min Jong; Park, Gye Young; Yoo, Chul Gyu; Chung, Hee Soon; Kim, Young Whan; Han, Sung Koo; Shim, Young Soo

Abstract

BACKGROUND
Lung cancer continues to be the leading cause of cancer death in the United States and it's incidence has been rapidly increasing in Korea, too. The overall cure rate for non-small cell lung cancer(NSCLC) is approximately 10%, and the cure is generally achieved by surgery. Unfortunately, however, less than 15% of all patients and less than 25% of those who present with localized disease are candidates for curative surgical resection. So preoperative staging evaluation followed by curative resection has a major role in determining the long term prognosis of NSCLC patients. Therefore, we have conducted this study to compare pre-operative and post-operative staging and the long-term relapse-free survival rates in NSCLC patients according to its stage.
METHODS
We analyzed the medical records of 217 NSCLC patients who were operated on for curative resection in Seoul National University Hospital, retrospectively. Among them, 170 patients who were completely resected were selected to determine the long term relapse-free survival rates.
RESULTS
Among 217 NSCLC patients, men were 157 and women were 30. The median age was 58 and the difference between men and women was not found. The discrepancy rate between preoperative and postoperative staging was 40.1%. Its major cause was due to the difference of nodal staging. The 3-year relapse-free survival rates were 73%, 53% and 48% in stage I, II and IIIa, respectively. There was no difference of relapse-free duration in recurred patients according to the stage or histologic types.
CONCLUSION
The postoperative pathologic staging determines the long term prognosis of patients with NSCLC after surgery, but current preoperative clinical staging can not predict the postoperative pathologic staging correctly. So the improved modality of staging system is required to predict the pathologic staging more correctly.