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Long-Term Prognosis and Prognostic Indicators of Stage IA Lung Adenocarcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The 8th edition of the TNM stage classification of lung cancer was developed based on an evaluation of the 5-year prognosis using an international database. Since recurrence after 5 years postoperatively is known to develop, the applicability of the stage classification beyond 5 years after treatment needs to be evaluated.

Patients and Methods

Postoperative prognosis and prognostic indicators were analyzed using data for 648 patients of pathological stage IA adenocarcinoma, who underwent complete resection between 2007 and 2012.

Results

The median age was 66 years (interquartile range 60–73 years), and the median follow-up duration was 100 months (interquartile range 70–116 months). Overall survival probabilities for pathological stage IA1, IA2, and IA3 patients were 100%, 96.3%, and 91.5% at 5 postoperative years, and 94.2%, 89.8%, and 83.5% at 10 postoperative years, respectively (IA1 vs IA2: p = 0.05; IA2 vs IA3: p = 0.05). Multivariate analysis for overall survival of patients who survived without recurrence for 5 postoperative years revealed that age (hazard ratio 3.21, p = 0.02) was the only factor that was significantly associated with long-term survival. Stage classification (IA1, IA2, or IA3) was not an associated factor. The incidence of secondary primary lung cancer continued to increase, resulting in an estimated probability of 8.6% at 10 postoperative years.

Conclusions

For patients who survived without recurrence for 5 postoperative years, age, not stage classification, was associated with survival thereafter. The long-term follow-up strategy does not need to be modified according to the stage classification, and screening for secondary primary lung cancer should be considered.

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Acknowledgment

We thank members of the Division of Biostatistics at the National Cancer Center for offering fruitful opinions and suggestions on the statistical methods.

Funding

This work was supported in part by KAKENHI grants from the Ministry of Education, Culture, Sports, Science, and Technology [Grant Numbers 16KT0197 (Kouya Shiraishi) and 20H00545 (Takashi Kohno)] and a grant from the Japan Agency for Medical Research and Development [Grant Number 19ck0106323h003 (Shun-ichi Watanabe)].

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Authors and Affiliations

  1. Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan

    Masaya Yotsukura MD, Yuji Muraoka MD, Yukihiro Yoshida MD, Kazuo Nakagawa MD & Shun-ichi Watanabe MD

  2. Division of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan

    Kouya Shiraishi PhD & Takashi Kohno PhD

  3. Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan

    Yasushi Yatabe MD

Authors
  1. Masaya Yotsukura MD
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  2. Yuji Muraoka MD
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  3. Yukihiro Yoshida MD
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  4. Kazuo Nakagawa MD
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  5. Kouya Shiraishi PhD
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  6. Takashi Kohno PhD
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  7. Yasushi Yatabe MD
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  8. Shun-ichi Watanabe MD
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Corresponding author

Correspondence to Masaya Yotsukura MD.

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Disclosure

Yasushi Yatabe has received personal fees outside of this work from MSD, Chugai Pharmaceutical, Astra Zeneca, Pfizer Japan, Roche/Ventana, Agilent/Dako, Thermo Fisher Scientific, Archer CD, Novartis Pharma, Eli Lilly Japan, Amgen, Merck Biopharma, Sysmex, Bayer, and Daiichi Sankyo. Takashi Kohno has received personal fees outside of this work from Chugai Pharmaceutical, Eli Lilly Japan, and Sysmex Corporation.

Ethical Approval

The study protocol was approved by the Medical Research Ethics Committee of the National Cancer Center (IRB approval no. 2015-289), and all experiments were conducted in accordance with the Declaration of Helsinki. The requirement for informed consent was waived by the committee since our study was a retrospective review of patient records.

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Yotsukura, M., Muraoka, Y., Yoshida, Y. et al. Long-Term Prognosis and Prognostic Indicators of Stage IA Lung Adenocarcinoma. Ann Surg Oncol 30, 851–858 (2023). https://doi.org/10.1245/s10434-022-12621-x

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  • DOI: https://doi.org/10.1245/s10434-022-12621-x

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