부산대학교 도서관

Objective. Clinical trials have indicated a benefit of postoperative adjuvant chemotherapy for patients with stage IB-IIIA non-small-cell lung cancer (NSCLC). We evaluated potential clinical factors that would affect recurrence in pathological stage IB patients. Methods. A total of 225 patients with stage IB NSCLC underwent a complete resection with systematic mediastinal lymphadenectomy at our department from 1982 through 2001. We evaluated factors that would potentially affect postoperative recurrence: they included age, sex, smoking status, preoperative serum CEA level, laterality, type of surgery, tumor size, histology, tumor grade, extent of pleural invasion. Results. The overall survival rates at 5 and 10 years were 73% and 57%, respectively. Recurrence was documented in 87 patients (39%). The recurrence-free survival rates at 5 and 10 years were 63% and 51%, respectively. Univariate analysis demonstrated that tumor size was associated with recurrence. The recurrence-free survival rate at 5 years was 70% among patients with tumors<4.0cm in diameter, 57% among those with tumors≥4.0 cm in diameter (P=0.018). The recurrence-free survival rate at 5 years was significantly better in patients with large cell and squamous cell histologic features compared with adenosquamous features. Multivariate analysis demonstrated that tumor size was the only significant independent factor for recurrence (P=0.0089), and that histology was marginally significant (P=0.068). Conclusion. Some patients with stage IB NSCLC, particularly among patients with tumors <4.0 cm in diameter and with histologic subtypes of large cell carcinoma and squamous cell carcinoma, might be categorized as being at lower risk for recurrence and hence, do not need adjuvant chemotherapy.