A clinical model to estimate recurrence risk in resected stage I non-small cell lung cancer

Boone Goodgame, Avinash Viswanathan, C. Ryan Miller, Feng Gao, Bryan Meyers, Richard J. Battafarano, Alexander Patterson, Joel Cooper, Tracey J. Guthrie, Jeffrey Bradley, Giancarlo Pillot, Ramaswamy Govindan

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Objective: There are no reliable markers to predict recurrence in resected Stage I non-small cell lung cancer (NSCLC). A validated clinical model to estimate the risk of recurrence would help select patients for adjuvant therapy. Methods: We reviewed the medical records of 715 patients who had a potentially curative resection for Stage I NSCLC at our institution from 1990 to 2000. Recurrence rates were estimated by the Kaplan-Meier method. A model to estimate risk of recurrence was developed by combining independent risk factors. Results: With a median follow-up of 4.7 years, the 5-year survival rates for Stages IA and IB were 66% and 55% respectively, and 5-year recurrence rates were 19% and 30%, respectively. Four factors were independently associated with tumor recurrence: tumor size > 3 cm (hazard ratio [HR] = 2.4), surgery other than lobectomy (HR = 2.0), nonsquamous histology (HR = 1.4), and high-grade cellular differentiation (HR = 1.4). A scoring system for recurrence was developed by assigning 2 points for each major risk factor (tumor size and surgery) and 1 point for each minor risk factor (histologic subtype and cellular grade). Scores were grouped as low (0 -1), intermediate (2-3), and high (>3), yielding 5-year estimates of risk of recurrence of 14%, 27%, and 43%, respectively. Conclusion: This model, based upon readily available clinicopathologic characteristics, can estimate the risk of recurrence in Stage I NSCLC, independent of T classification. This model could be used to select patients for adjuvant therapy if validated in independent data sets.

Original languageEnglish
Pages (from-to)22-28
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Issue number1
StatePublished - Feb 2008


  • Early stage
  • Non-small cell lung cancer
  • Prognostic index
  • Recurrence


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