Survival Analysis of Patients With Stage I Non-Small-Cell Lung Cancer Using Clinical and DNA Repair Pathway Expression Variables

• Type of Material: Article
• Authors: Madhusmita Behera, Emory University; John J. Heine, University of South Florida; Gabriel Sica, Emory University; Erin E. Fowler, University of South Florida; Ha Tran, Emory University; Robert W. Fu, Emory University; Anthony A Gal, Emory University; Robert Hermann, WellStar Kennestone Hospital; William Mayfield, WellStar Kennestone Hospital; Fadlo Khuri, Emory University; Taofeek K Owonikoko, Emory University; Suresh S Ramalingam, Emory University
• Language: English
• Date: 2013-03-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.cllc.2012.06.001
• Title of Journal or Parent Work: Clinical Lung Cancer
• ISSN: 1525-7304
• Volume: 14
• Issue: 2
• Start Page: 128
• End Page: 138
• Grant/Funding Information: Supported by NIH P01 CA166999.; GLS, FRK, TKO, and SSR are recipients of the Distinguished Cancer Scholar award from the Georgia Cancer Coalition.
• Keywords: ADJUVANT CHEMOTHERAPY; Oncology; TRENDS; POOLED ANALYSIS; TRIALS; DNA repair; Cox regression; Logistic regression; Science & Technology; Life Sciences & Biomedicine; PARP; MORTALITY; Kaplan-Meier; Ku86; NSCLC
• Research Categories: Health Sciences, Oncology; Health Sciences, Public Health

Abstract

Background: Lung cancer is the leading cause of cancer-related mortality. Understanding patient attributes that enhance survival and predict recurrence is necessary to individualize treatment options. Methods: Patients (N = 162) were dichotomized into favorable (n = 101) and unfavorable (n = 61) groups based on survival characteristics. Ku86 and poly(ADP-ribose) polymerase (PARP) expression measures were incorporated into the analyses. LR, Kaplan-Meier analysis, and Cox regression were used to investigate intervariable relationships and survival. Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess associations. Results: Sex (OR, 0.32; CI-0.14, 0.76), squamous cell carcinoma (SCC) (OR, 0.41; CI-0.17, 0.98), and recurrence (OR, 0.04; CI-0.01, 0.20) confer an unfavorable outcome with area under the receiver operating characteristic curve (Az) = 0.788. Patients with increased tumor grade (OR = 1.84; CI-1.06, 3.19) or increased Ku86 intensity (OR, 2.03; CI-1.08, 3.82) were more likely to be male individuals, and older patients (OR, 1.70; CI-(1.14, 2.52) were more likely to have SCC. Patients older than the median age (HR, 1.86; CI-1.11, 3.12), patients with SCC (HR, 1.78; CI-1.05, 3.01), patients with recurrence (HR, 4.16; CI-2.37, 7.31), and male patients (HR, 2.03; CI-1.20, 3.43) have a higher hazard. None of the DNA repair measures were associated with significant HRs. Conclusion: Clinical and pathologic factors that enhance and limit survival for patients with stage I NSCLC were quantified. The DNA repair measures showed little association. These findings are important given that certain clinical and pathologic features are related to better long-term survival outcome than others.