Predicting recurrence following curative surgery in stage I non-small cell lung cancer patients using an...

There are still difficulties in determining the risk of recurrence to decide whether to perform selective adjuvant treatment for stage I non-small cell lung cancer. This study reviewed 122 stage I patients who underwent curative surgery to assess the usefulness of an angiogenesis-associated factor as a predictor of recurrence. By immunohistochemical examination, we collected information about tumor-induced vascular endothelial growth factor (VEGF)-A and -C expression at the primary site. During the median follow-up period of 120 months, the overall 10-year survival rate was 53.5%. The 10-year survival rates according to VEGF-A/C expression were as follows: VEGF-A high/VEGF-C high group, 26.0%; VEGF-A high/VEGF-C low group, 42.7%; VEGF-A low/VEGF-C high group, 73.1%; VEGF-A low/VEGF-C low group, 65.1%. The VEGF-A high/VEGF-C high group showed the worst outcome. The diagnostic values of the marker combination for predicting recurrence were as follows: sensitivity, 71.4%; specificity, 63.8%; and accuracy, 65.6%. When stratified by T factor, preferable high values for both negative predictive value and specificity were obtained in patients with stage IA disease. In order to select the patients eligible for selective adjuvant therapy at early stages, especially in stage IA disease, simultaneous assessment of tumor-induced VEGF-A/C warrants further study.