Age, tumor size, type of surgery, and gender predict survival in early stage (stage I and II) non-small cell lung cancer after surgical resection

Background: Even after presumably curative resection the 5-year survival rates are only 60-80% in stage I and 40-50% in stage II NSCLC. Purpose of the present study was the identification of independent clinico-pathological predictors of their survival. Methods: A retrospective review of 519 consecutive subjects who had undergone attempted curative resection for stage I or II NSCLC was performed. Patients who had received any adjuvant or neo-adjuvant chemo- or radiation therapy were excluded. Primary outcome measure was the duration of overall survival. Results: Median survival was 7.25 years for stage IA, 5.71 years for stage IB and 3.85 years for stage IIB. In univariate analysis, six variables were significantly associated (p-value < 0.05) with poorer survival: older age, larger size of the tumor, male gender, surgery other than lobectomy, squamous histology and later stages (stage IB and IIB). In multivariate analysis, age (Hazard ratio = 1.06 per year increase in age; p < 0.0001). larger tumor size (Hazard ratio = 1.54 per doubling of tumor size; p < 0.0001), type of surgery (Hazard ratio = 1.50 for surgery other than lobectomy; p = 0.036), and gender (Hazard ratio = 1.45 for male gender; p = 0.039) were the predictors of overall survival. Conclusions: In surgically treated early stage (I and II) NSCLC patients, age, tumor size, type of surgery, and gender are the important predictors of survival. (C) 2009 Elsevier Ireland Ltd. All rights reserved.