Completely Resected N0 Non-Small Cell Lung Cancer: Prognostic Factors Affecting Long-Term Survival

Background. Although early stage non-small cell lung cancer (NSCLC) has an excellent outcome and correlated with good long-term survival, up to 15 percent of patients still relapse postoperatively and die. This study is conducted to identify prognostic factors that may affect the long-term survival in completely resected N0 NSCLC. Methods. Medical records of 124 patients with completely resected N0 NSCLC were retrospectively reviewed. Prognostic factors affecting long-term survival were analyzed by the Kaplan-Meier method and Cox proportional hazards analysis. Results. Overall five-year survival rate was 48 percent. Multivariable analysis revealed stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases as significant prognostic factors affecting long-term survival. The hazard ratio (HR) of tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases was 2.0, 2.3, 7.6, 4.1, and 8.3, respectively, and all P values were less than 0.001. Conclusions. Our study shows stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastasis, and skin metastasis as the independent prognostic factors of long-term survival in pathological N0 NSCLC. Early stage NSCLC patients without nodal involvement or presented with tumor necrosis should benefit from adjuvant chemotherapy, and sites of metastasis could predict the long-term survival as described.

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64 STATISTICAL ANALYSIS OF PROGNOSTIC FACTORS AFFECTING LONG-TERM PROGNOSIS AFTER ENDOSCOPIC TREATMENT OF ESOPHAGEAL VARICES

Diseases of the Esophagus ◽

10.1093/dote/doaa087.10 ◽

2020 ◽

Vol 33 (Supplement_1) ◽

Author(s):

T Nishimura

Keyword(s):

Prognostic Factors ◽

Esophageal Varices ◽

Endoscopic Treatment ◽

Survival Period ◽

Term Survival ◽

Gastroesophageal Varices ◽

Long Term Survival ◽

Factors Affecting ◽

Long Term Prognosis

Abstract Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 260 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and June 2019. Among them, 160 successfully followed up. The patients’ characteristics were: mean age, 65.4 years (29–85); 109 men and 51 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The long-term/non-long-term survival group had a preoperative Child-Pugh score of 6.2 ± 1.1/7.4 ± 2.0 (p < 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.4%/55.9% (p < 0.01), significantly higher in the non-long-term group. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, p < 0.05], total bilirubin value≧ 2 [HR:2.5573, p < 0.05], and presence of HCC [HR:2.2450, p < 0.01] were noted as significant factors. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio:0.3463, p < 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices.

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