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J Thorac Cardiovasc Surg 2003;126:558-562
© 2003 The American Association for Thoracic Surgery

General thoracic surgery

Long-term survival and prognostic factors of five-year survivors with complete resection of non–small cell lung carcinoma

^a From the Department of Thoracic Surgery, Hyogo Medical Center for Adults, Akashi City, Hyogo, Japan

Received for publication September 11, 2002; accepted for publication December 27, 2002.

^* Address for reprints: Noriaki Tsubota, MD, PhD, Department of Thoracic Surgery, Hyogo Medical Center for Adults, Kitaohji-cho 13-70, Akashi City 673-5885, Hyogo, Japan
n-tsubo{at}sanynet.net.jp

OBJECTIVE: We analyzed the long-term follow-up data on cancer-related death in 5-year survivors of complete resection of their non–small cell lung cancer and examined the prognostic factors having an impact on subsequent survival.

METHODS: Of 848 consecutive patients with proven primary non–small cell carcinoma who underwent complete removal of the primary tumor together with hilar and mediastinal lymph nodes, 421 patients (49.6%) survived 5 years or longer after the initial surgical treatment. Of all the data analyzed, only death related to cancer was treated as death.

RESULTS: The median follow-up of 5-year survivors was 84 months from the original treatment (range, 60 to 200 months). Their overall survival rate at 10 years was 91.0%. Multivariable Cox analysis demonstrated that although advanced surgical-pathological stage (P = .0001), nodal involvement (P = .0245), male gender (P = .0313), and non–squamous type of the tumor (P = .0034) were significant, independent, unfavorable prognostic determinants in all patients, none of the variables investigated significantly influenced the long-term survival of 5-year survivors. The rate of recurrence beyond 5 years was much lower compared with that within 5 years. In contrast, the rate of occurrence of new malignancies was unchanged throughout the long-term postoperative period.

CONCLUSIONS: Among 5-year survivors of complete resection of non–small cell lung cancer, neither stage, nodal status, sex, nor histologic condition further affected subsequent survival, suggesting that the 5-year interval might be sufficient to declare that a patient with lung cancer has been cured.

Key Words: 10

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