Kelsey et al identified histologic features that can identify a patient with lung cancer who is more likely to have a local recurrence following surgery for early stage disease. These can identify a patient who may benefit from more aggressive management. The authors are from Duke University.
Patient selection: surgical lobectomy of an early stage nonsmall cell lung cancer with negative surgical margins
Parameters:
(1) histologic type
(2) lymphovascular invasion
Parameter |
Finding |
Points |
histologic type |
adenocarcinoma |
0 |
|
squamous cell or large cell undifferentiated carcinoma |
1 |
lymphovascular invasion |
absent |
0 |
|
present |
1 |
total risk score =
= SUM(points for both parameters)
Interpretation:
• minimum risk score: 0
• maximum risk score: 2
• The higher the risk score the more likely that a local recurrence would occur.
Total Risk Score |
5-Year Risk of Local Recurrence |
0 |
13% |
1 |
32% |
2 |
47% |
Additional factors associated with local recurrence:
(1) stage IB or II (vs stage IA)
(2) sublobar resection
(3) positive resection margin
Specialty: Hematology Oncology, Surgery, general, Pulmonology
ICD-10: ,