Poor survival for veterans with pathologic stage I non-small-cell lung cancer.

St Julien JB, Pinkerman R, Aldrich MC, Chen H, Deppen SA, Callaway-Lane C, Massion P, Putnam JB, Lambright ES, Nesbitt JC, Grogan EL. Poor survival for veterans with pathologic stage I non-small-cell lung cancer. American journal of surgery. 2012 Nov 1; 204(5):637-42.

Related HSR&D Project(s)

• CDA 10-024 – Decreasing Unnecessary Invasive Lung Cancer Diagnostic Procedures

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Abstract:

BACKGROUND: Pathologic stage (pStage) IA and IB non-small-cell lung cancer (NSCLC) has a median survival time of 119 and 81 months, respectively. We describe the outcomes of veterans with pStage I NSCLC. METHODS: A retrospective review of 78 patients with pStage I NSCLC who underwent cancer resection was performed at the Tennessee Valley Veterans Affairs Hospital between 2005 and 2010. All-cause 30-day, 90-day, and overall mortality were determined. Survival was assessed with the Kaplan-Meier and Cox proportional hazards methods. RESULTS: There were 55 (71%) pStage IA and 23 (29%) IB patients. Thirty- and 90-day mortality was 3.8% (3 of 78) and 6.4% (5 of 78), respectively. Median survival was 59 and 28 months for pStage 1A and 1B, respectively. Postoperative events were associated with impaired survival on multivariable analysis (hazard ratio, 1.26, P = .03). CONCLUSIONS: Veterans with pStage I NSCLC at our institution have poorer survival than the general population. More research is needed to determine the etiology of this disparity.