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Kang, Cho, Lee, Park, Lee, Lee, Kim, and Park: Cell Differentiation Might Predict the Recurrence in Surgically Resected Non-Small Cell Lung Carcinoma
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 68(1): 10-15.

Published online: 31 January 2010

DOI: https://doi.org/10.4046/trd.2010.68.1.10

Cell Differentiation Might Predict the Recurrence in Surgically Resected Non-Small Cell Lung Carcinoma

Hyung Koo Kang, M.D., Sung Gun Cho, M.D., Hye-Min Lee, M.D., Sung Woon Park, M.D., Byung Ook Lee, M.D., Jae Hee Lee, M.D., Bo Min Kim, M.D., In Won Park, M.D.

Division of Respiratory and Allergy Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

Address for correspondence: In Won Park, M.D. Division of Respiratory and Allergy Medicine, Department of Internal Medicine, Chung-Ang University Hospital, 224-1, Heukseok-dong, Dongjak-gu, Seoul 156-070, Korea. Phone: 82-2-6299-1401, Fax: 82-2-825-7571, iwpark@cau.ac.kr

Received 4 December 2009       Accepted 11 December 2009

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

Lung cancer is the most common cause of cancer mortality in Korea. The TNM stage at presentation in patients with non-small cell lung cancer (NSCLC) has the greatest impact on prognosis. Patients who undergo a complete resection for NSCLC are likely to develop recurrent and/or metastatic disease. There are several factors influencing the development of recurrence. We explored risk factors of recurrence in patients with stages I and II NSCLC, who had undergone curative resection.

Methods

We reviewed patients who had complete surgical resection as definitive treatment for stage I or II. Patients followed up for more than 36 months. We evaluated several factors which might have relationship with recurrence, such as patient's demographic factors, TNM staging, pathologic finding, tumor markers and surgical technique.

Results

A total of 75 patients were enrolled for analysis, of whom 58 were men and 17 were women with mean age of 61 (range, 37 to 76) years. The average size of tumors was 3.9 cm (0.7 to 10 cm). There were 64 patients with stage I NSCLC and 11 with stage II NSCLC. Among 64 patients with stage I NSCLC, 35 patients showed recurrences whereas 8 patients have recurred in stage II NSCLC. Grade of differentiation of tumor was closely related to the recurrence. Seventy-five percent of patients who had poor tumor differentiation experienced a recurrence. In contrast, 3 patients of twelve had recurrences, who revealed differentiation in their tissue (p<0.05).

Conclusion

Tumor differentiation could be a predictive factor for tumor recurrence in patients who have undergone curative resection for stage I or II NSCLC.

Keywords: Carcinoma, Non-Small-Cell Lung, Recurrence, Risk Factors, Cell Differentiation

Figures and Tables

Figure 1
Patient population enrolled and excluded in this study.
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Figure 2
Recurrence rate of patients with stage I, II stratified by differentiation.
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Figure 3
The Kaplan-Meier survival curves in patients with stage I, II non-small cell lung cancer stratified by histologic grades.
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Table 1
Demographics of study subjects
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Table 2
Comparison of recurrence between stage I and stage II
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Table 3
Comparison of recurrence characteristics between local and remote recurrence
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Table 4
Relationship between recurrence and clinicopathologic factors in stage I, II non-small cell lung cancer
trd-68-10-i004

CEA: carcioembryonic antigen; RUL: right upper lobe; RML: right middle lobe; RLL: right lower lobe; LUL: left middle lobe; LLL: left lower lobe.

*p<0.05.

Table 5
Relationship between recurrence and clinicopathologic factors in stage I non-small cell lung cancer
trd-68-10-i005

CEA: carcioembryonic antigen; RUL: right upper lobe; RML: right middle lobe; RLL: right lower lobe; LUL: left middle lobe; LLL: left lower lobe.

*p<0.05.

Table 6
Multivariate analysis for relationship between recurrence and histologic grade
trd-68-10-i006

OR: odds ratio; CI: confidence interval.

Table 7
Relationship between recurrence and lymphovascular tumor emboli
trd-68-10-i007

Notes

This research was supported by the Chung-Ang University research grant in 2007.

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