Objective: To investigate the effect of complete resection standards on the prognosis of non-small cell lung cancer.
Methods: Clinical data of 2 711 inpatient cases treated from January 2000 to December 2008 at our hospital were retrospectively reviewed. The relationship between surgical resection standard and the overall survival and other factors affecting the overall survival was analyzed.
Results: The overall 5-year survival rate was 44.6%. The overall 5-year survival rate of stage IA, IB, IIA, IIB, IIIA cases was 60.5%, 55.4%, 43.1%, 37.0% and 28.1%, respectively. The 5-year survival rate of patients who underwent complete resection was 50.3%, and that of patients who underwent incomplete resection was only 40.1% (P < 0.01). The main prognostic factors were operation type, resection margin, pathological type, T stage, N stage, TNM stage, the number of dissected lymph node (LN) stations (<6 and ≥ 6), the number of resected lymph nodes (1-10, 11-20, and >20), postoperative radiotherapy and complete resection (P < 0.05 for all). Cox regression suggested that TNM stage and complete resection were independent factors affecting the prognosis. Adjuvant chemotherapy affected the prognosis of stage II-IIIA patients.
Conclusions: TNM stage and complete resection are independent factors affecting the prognosis of NSCLC patients. The 5-year survival rate of NSCLC has significantly increased through promoting the standard of operation, especially increasing the standard of lymph node dissection. The standard of complete resection should be recommended to be used in clinical practice. Adjuvant chemotherapy is beneficial for stage II-IIIA NSCLC patients.