A clinical model to estimate recurrence risk in resected stage I non-small cell lung cancer

Boone Goodgame, Avinash Viswanathan, C. Ryan Miller, Feng Gao, Bryan Meyers, Richard J Battafarano, Alexander Patterson, Joel Cooper, Tracey J. Guthrie, Jeffrey Bradley, Giancarlo Pillot, Ramaswamy Govindan

Research output: Contribution to journalArticle

Abstract

Objective: There are no reliable markers to predict recurrence in resected Stage I non-small cell lung cancer (NSCLC). A validated clinical model to estimate the risk of recurrence would help select patients for adjuvant therapy. Methods: We reviewed the medical records of 715 patients who had a potentially curative resection for Stage I NSCLC at our institution from 1990 to 2000. Recurrence rates were estimated by the Kaplan-Meier method. A model to estimate risk of recurrence was developed by combining independent risk factors. Results: With a median follow-up of 4.7 years, the 5-year survival rates for Stages IA and IB were 66% and 55% respectively, and 5-year recurrence rates were 19% and 30%, respectively. Four factors were independently associated with tumor recurrence: tumor size > 3 cm (hazard ratio [HR] = 2.4), surgery other than lobectomy (HR = 2.0), nonsquamous histology (HR = 1.4), and high-grade cellular differentiation (HR = 1.4). A scoring system for recurrence was developed by assigning 2 points for each major risk factor (tumor size and surgery) and 1 point for each minor risk factor (histologic subtype and cellular grade). Scores were grouped as low (0 -1), intermediate (2-3), and high (>3), yielding 5-year estimates of risk of recurrence of 14%, 27%, and 43%, respectively. Conclusion: This model, based upon readily available clinicopathologic characteristics, can estimate the risk of recurrence in Stage I NSCLC, independent of T classification. This model could be used to select patients for adjuvant therapy if validated in independent data sets.

Original languageEnglish (US)
Pages (from-to)22-28
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume31
Issue number1
DOIs
StatePublished - Feb 2008
Externally publishedYes

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Non-Small Cell Lung Carcinoma
Recurrence
Neoplasms
Medical Records
Histology
Survival Rate
Therapeutics

Keywords

  • Early stage
  • Non-small cell lung cancer
  • Prognostic index
  • Recurrence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Medicine(all)

Cite this

A clinical model to estimate recurrence risk in resected stage I non-small cell lung cancer. / Goodgame, Boone; Viswanathan, Avinash; Miller, C. Ryan; Gao, Feng; Meyers, Bryan; Battafarano, Richard J; Patterson, Alexander; Cooper, Joel; Guthrie, Tracey J.; Bradley, Jeffrey; Pillot, Giancarlo; Govindan, Ramaswamy.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 31, No. 1, 02.2008, p. 22-28.

Research output: Contribution to journalArticle

Goodgame, B, Viswanathan, A, Miller, CR, Gao, F, Meyers, B, Battafarano, RJ, Patterson, A, Cooper, J, Guthrie, TJ, Bradley, J, Pillot, G & Govindan, R 2008, 'A clinical model to estimate recurrence risk in resected stage I non-small cell lung cancer', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 31, no. 1, pp. 22-28. https://doi.org/10.1097/COC.0b013e3180ca77d1
Goodgame, Boone ; Viswanathan, Avinash ; Miller, C. Ryan ; Gao, Feng ; Meyers, Bryan ; Battafarano, Richard J ; Patterson, Alexander ; Cooper, Joel ; Guthrie, Tracey J. ; Bradley, Jeffrey ; Pillot, Giancarlo ; Govindan, Ramaswamy. / A clinical model to estimate recurrence risk in resected stage I non-small cell lung cancer. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 2008 ; Vol. 31, No. 1. pp. 22-28.
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AU - Meyers, Bryan

AU - Battafarano, Richard J

AU - Patterson, Alexander

AU - Cooper, Joel

AU - Guthrie, Tracey J.

AU - Bradley, Jeffrey

AU - Pillot, Giancarlo

AU - Govindan, Ramaswamy

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N2 - Objective: There are no reliable markers to predict recurrence in resected Stage I non-small cell lung cancer (NSCLC). A validated clinical model to estimate the risk of recurrence would help select patients for adjuvant therapy. Methods: We reviewed the medical records of 715 patients who had a potentially curative resection for Stage I NSCLC at our institution from 1990 to 2000. Recurrence rates were estimated by the Kaplan-Meier method. A model to estimate risk of recurrence was developed by combining independent risk factors. Results: With a median follow-up of 4.7 years, the 5-year survival rates for Stages IA and IB were 66% and 55% respectively, and 5-year recurrence rates were 19% and 30%, respectively. Four factors were independently associated with tumor recurrence: tumor size > 3 cm (hazard ratio [HR] = 2.4), surgery other than lobectomy (HR = 2.0), nonsquamous histology (HR = 1.4), and high-grade cellular differentiation (HR = 1.4). A scoring system for recurrence was developed by assigning 2 points for each major risk factor (tumor size and surgery) and 1 point for each minor risk factor (histologic subtype and cellular grade). Scores were grouped as low (0 -1), intermediate (2-3), and high (>3), yielding 5-year estimates of risk of recurrence of 14%, 27%, and 43%, respectively. Conclusion: This model, based upon readily available clinicopathologic characteristics, can estimate the risk of recurrence in Stage I NSCLC, independent of T classification. This model could be used to select patients for adjuvant therapy if validated in independent data sets.

AB - Objective: There are no reliable markers to predict recurrence in resected Stage I non-small cell lung cancer (NSCLC). A validated clinical model to estimate the risk of recurrence would help select patients for adjuvant therapy. Methods: We reviewed the medical records of 715 patients who had a potentially curative resection for Stage I NSCLC at our institution from 1990 to 2000. Recurrence rates were estimated by the Kaplan-Meier method. A model to estimate risk of recurrence was developed by combining independent risk factors. Results: With a median follow-up of 4.7 years, the 5-year survival rates for Stages IA and IB were 66% and 55% respectively, and 5-year recurrence rates were 19% and 30%, respectively. Four factors were independently associated with tumor recurrence: tumor size > 3 cm (hazard ratio [HR] = 2.4), surgery other than lobectomy (HR = 2.0), nonsquamous histology (HR = 1.4), and high-grade cellular differentiation (HR = 1.4). A scoring system for recurrence was developed by assigning 2 points for each major risk factor (tumor size and surgery) and 1 point for each minor risk factor (histologic subtype and cellular grade). Scores were grouped as low (0 -1), intermediate (2-3), and high (>3), yielding 5-year estimates of risk of recurrence of 14%, 27%, and 43%, respectively. Conclusion: This model, based upon readily available clinicopathologic characteristics, can estimate the risk of recurrence in Stage I NSCLC, independent of T classification. This model could be used to select patients for adjuvant therapy if validated in independent data sets.

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