Influence of factors on long-term survival of stage I NSCLC by detection of micrometastatic tumor cells in pN0 lymph nodes.

Abstract

Objective To explore the influence of some factors on long-term survival of postoperative stage Ⅰ NSCLC patients. Methods 91 patients of NSCLC who underwent radical surgery of the primary tumor with dissection of the hilar and mediastinal lymph nodes were diagnosed as stage Ⅰ NSCLC postoperatively by pathology and followed up for 5 years. Its hilar and subcarinal lymph nodes were detected occult micrometastastic tumor cells by immunohistochemistry (SP method) by using the binoclonal antibody multicytokeratin (AE1/AE3) as a micrometastatic marker. To analyse the influence of micrometastasis and the clinicopathologic characteristics on long-term survivals. Results The rate of micromatastasis of stage Ⅰ NSCLC was 49 %. The five-year overall survival rate was 70.3 %. The median of survival time was 48.5months. The rate of metastasis was 32 % and the meantime of relapse and metastasis was 36.6months. Tumor size, differentiation, stage, and micrometastasis were significantly associated with relapse and metastasis (P <0.05). The tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival in multivariate analysis (P<0.05). Conclusion There was nodal micrometastasis in completely resected stage Ⅰ NSCLC, and the tumor differentiation, stage, and micrometastasis were found to be significant independent factor on survival. Key words: Carcinoma, non-small-cell lung; Neoplasm metastasis; Disease-free survival