Objective: To evaluate and analyze prognostic factors for surgical treatment of patients with neoadjuvant chemotherapy.
Methods: Records of 256 patients who underwent operation after chemotherapy for lung cancer from June 1995 to May 2007 were reviewed retrospectively. Potential prognostic factors which were univariately and multivariately analyzed by COX proportional hazard regression model, included gender, age, p-TNM stage, size of tumor, metastasis of lymph node, histological type and operation extent. Kaplan-Meier method was used for survival curve and rate. However, survival difference was calculate by Log-rank test.
Results: Eleven patients (4.3%) developed postoperative complications. Two hundred and thirty-six patients (92.2%) underwent radical resection (169 for lobectomies, 53 for pneumonectomies and 14 for extended resections). On the contrary, 20 cases had palliative resection. The overall 1-, 3- and 5-year survival rate was 79.3%, 38.7% and 27.0% respectively. Age, p-TNM stage, size of tumor, metastasis of lymph node and type of operation were valued as prognostic factors in COX univariate analysis, p-TNM stage (OR = 1.323, 95% CI: 1.068 to 1.641, P = 0.017) and age (OR = 1.562, 95% CI: 1.148 to 2.125, P = 0.005) were identified independent prognostic factors in COX multivariate analysis.
Conclusions: Long-term outcome for lung cancer of patients with neoadjuvant chemotherapy are encouraging, p-TNM stage and surgical type are the crucial prognostic factors for surgical treatment of patients with neoadjuvant chemotherapy.