Determinants of relapse and survival in completely ressected non small cell lung cancer

INTRODUCTION: Lung ressection is the treatment of choice in Non-Small Cell Lung Cancer (NSCLC). Besides TNM staging, other features have been reported as significant prognostic factors. AIM: To analyze factors affecting relapse and survival in NSCLC after complete ressection. METHODS: A retrospective study was conducted, including patients with NSCLC completely ressected in the last 12 years. Clinical and histological factors were assessed and its influence on survival free of relapse and overall survival was determined. RESULTS: 160 patients were included, 77.5% male and 22.5% female, with a median age of 65years. Relapse occurred in 69 patients (median survival free of relapse - 56 months). At univariate analysis, an association was found between reduced survival free of relapse and age≤62 years, clinical tumor size≥4cm, clinical TNM stage>IB, clinical T>1, clinical N>0, pathological TNM stage>IB, pathological T>2, pathological N>0 and vascular invasion. At multivariate analysis, tumor size≥4cm (p=0.004), pathological TNM stage>IB (p=0.023) and vascular invasion (p=0.024) were associated to a reduced survival free of relapse. 64 patients died (median overall survival – 112 months). At univariate analysis, an association was found between reduced overall survival and age≤62 years, clinical tumor size≥4cm, clinical TNM stage>IB, clinical N>0, pathological TNM stage>IB, pathological T>2, pathological N>0, vascular invasion and poor differentiation of tumor. At multivariate analysis, only pathological TNM stage>IB (p=0.029) remained associated a poorer overall survival. CONCLUSION: Besides TNM staging, other features are important on relapse and survival and should be considered for adjuvant therapy.