Ignatius Ou S-H et al. (2007) Prognostic factors for survival of stage I nonsmall cell lung cancer patients: a population-based analysis of 19,702 stage I patients in the California Cancer Registry from 1989 to 2003. Cancer 110: 1532–1541

Of all patients diagnosed with lung cancer, only around 25% are likely to benefit from curative surgical resection—those with stage I or stage II disease. Ignatius Ou et al. carried out a population-based analysis of patients with stage I non-small-cell lung cancer (NSCLC) to identify features associated with increased risk of mortality.

The study analyzed data from the California Cancer Registry from 1989 to 2003, identifying 19,702 patients with stage I NSCLC. The most common age at diagnosis was 70–74 years. Several characteristics were shown to reduce the survival rate, including male sex, advanced age at diagnosis, low socioeconomic status, no surgical intervention and poorly differentiated histologic grade (stage IA NSCLC: hazard ratio 1.13, 95% CI 1.08–1.19; stage IB NSCLC: hazard ratio 1.11, 95% CI, 1.07–1.16). Tumors located outside the upper lobe and ≥4 cm in size also increased the risk of mortality for stage IB disease. The authors suggest that these factors should be considered during adjuvant trials. Further analysis of these features could help identify high-risk patients who may benefit from adjuvant chemotherapy.