Prognostic Markers in Resected Stage I and II Non-Small-Cell Lung Cancer: An Analysis of 260

We performed a retrospective analysis of potential prognostic markers in 260 patients with surgically resected stage I and II non–small-cell lung cancer (NSCLC) with a minimum 5-year follow-up. Cox proportional hazard models and Wilcoxon tests were employed to analyze the effect of patient characteristics on survival and disease-free survival (DFS). In the univariate analysis, the following were significant predictors of shorter overall survival: N-stage (N1 vs N0) (p 63.5 vs <63.5) (p= 0.03); mucin (positive vs negative) (p< 0.03). The following were significant predictors of shorter DFS: N-stage (p<0.001); T-stage (p=0.001); loss of antigen A (p=0.01); mucin expression (p<0.01); cough (p=0.02); Ki-67 expression (p=0.02) and negative bcl-2 expression (p=0.03). Analysis of survival difference for histologic subtype, degree of differentiation, aneuploidy, %S-phase, codon 12 K-ras mutation, and immunohistochemistry staining for Lewis y , p53, Rb, microvessel count, HER2, E-cadherin and neuroendocrine markers did not reach statistical significance. In multivariate analysis, the following predicted for shorter overall survival: N-stage (p<0.01), antigen A (p=0.01), age (p<0.01), and bcl-2 (p=0.05); and for DFS, N-stage (p <0.01), antigen A (p< 0.01), Ki-67 (p=0.03), mucin (p= 0.04) and T-stage (p= 0.05). Of all the clinical-pathological, proliferative, and biological markers studied, only a few carried independent prognostic significance.