[Effectiveness of adjuvant chemotherapy in patient with early stages of non-small cell lung cancer depending on proliferation index of tumor].

UNLABELLED: Adjuvant chemotherapy is a debatable question in patients with early stages of non-small cell lung cancer (NSCLC). Prognostic/predictive markers should be used for individualizing prescription of adjuvant chemotherapy. The aim of our study was to investigation effectiveness adjuvant chemotherapy in patients with early stages of NSCLC due to proliferation index of tumor. We included in study 254 patients with I-II stages of NSCLC that conducted treatment in department of thoracic surgery Zaporozhye regional clinical oncology center since June 2008 to December 2012. Expression Ki-67, proliferation marker, measured in 95 patients that used adjuvant chemotherapy and in 122 patients with out additional treatment. Measuring of proliferation index was don by next method: 0-5% immunopositive cells--0 point, 6-25%--1 point, 26-50%--2 point, 51-75%-- 3 point, 76-100%--4 point. High expression was > or = 2 points. RESULTS: Mean of proliferation index in patients with early stages of NSCLC was 37.6% (95% CI, 33.8-41.5%). Median of survival in patients with II stage of NSCLC was 39.7 month if patients conducted adjuvant chemotherapy and 21.4 month with out treatment. It was tendencies increasing survival in patients with II stage of NSCLC after adjuvant chemotherapy, but it was not statistically significant (P = 0.16). Survival patients with high proliferation index was 10.5 month--75 percentile, 18 month--median, 29.9 month--25 percentile. In patients after adjuvant chemotherapy 75 percentile of survival was 34.4 month, median of survival not complete. Survival differences of two group were statistically significant (P < 0.0001). Thus individualization of prescription adjuvant chemotherapy in patient with early stages of NSCLC helps improves results of treatment and avoid unreasonable toxic therapy.

[Effect of the intercellular adhesion molecule E-cadherin on the prognosis of non-small cell lung cancer].

The effect of E-cadherin on the prognosis of Stage I-II non-small cell lung cancer (NSCLC) was investigated. Tumor E-cadherin expression and its correlation with the clinical and morphological characteristics of a patient, as well as the prognostic role of this marker were studied. It was ascertained that the E-cadherin expression did not depend on patient gender and age, tumor histological pattern, location, grade, and pT category, but it was significantly related to the pN1 category (p < 0.0001). Univariate analysis revealed that the histological pattern of a tumor, nodal status, resection type (lobectomy/pulmonectomy), and E-cadherin expression level were significantly correlated with patient survival. Multivariate analysis showed that the important predictors were tumor histological pattern and resection type (p = 0.01 and p = 0.00004, respectively). A more complete study of the prognostic and predictive role of E-cadherin expression in patients with Stage I-II NSCLC will help identify a prognostically unfavorable group of patients who may be given additional treatment in the postoperative period.

[Lymph node dissection in patient operated for non small cell lung cancer in early stage].

At present time volume of lymph node dissection in patients with lung cancer is discussed. The aim of study was comparison efficiency of complete and partial mediastinal lymph node dissection. In 154 patients, who treated Zaporozhye Regional Clinical Oncology Center for non small cell lung cancer in early stage, complete mediastinal lymph node dissection was done in 44, and partial--in 110. Patients with T2-T3, peripheral tumor and pneumonectomy had worth survival if partial mediastinal lymph node dissection was completed. Independent prognostic factors were histologyc form of tumor, volume of operative intervention, volume of lymph node dissection. Therefore, complete mediastinal lymph node dissection increasing survival patients with early stage of lung cancer.

[The influence of microvessel density in the tumor on the prognosis in patients with stage I-II non-small cell lung cancer after surgical treatment].

A study of the prognostic role of microvessel density in tumors of patients with stage I-II non-small cell lung cancer (NSCLC) was performed from June 2008 to June 2011. Determination of microvessel density using the marker CD31 was conducted in 114 patients. Microvessel density was significantly correlated with tumor size: so at greater than 3 cm in diameter, the content of microvessels was 68.7 +/- 3.1, with a smaller tumor size--48.6 +/- 4.5. Independent prognostic markers in patients with stage I-II NSCLC after surgery are histological type (HR = 2.97), tumor size (HR = 4.5), and the number of microvessels in tumor (HR = 3.2).