Histologic Features of Kelsey et al Predictive of Local Recurrence in a Patient Following Surgery for Early Stage Nonsmall Cell Lung Cancer

Description

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

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Description

Specialty

ICD-10