Forecasting of Survival Rate in Patients with the Early Stage of Non Small Cell Lung Cancer

摘要

Lung cancer is the most common cause of death from oncological diseases all over the world. Primary treatment of patients with the early stage of non-small cell lung cancer is a surgery. However, after surgery 30% - 85% of patients undergo disease progression. In order to improve the results of treatment of patients with non-small cell lung cancer it is necessary to separate a group of patients with dismal prognosis for whom adjuvant chemotherapy will permit improving the survival rate. The aim of our research was to create a forecasting model with a view to detect the patients with the early stage of non-small cell lung cancer and dismal prognosis. Our research covered 254 patients with the early stage of non-small cell lung cancer who underwent a cure from June 2008 till December 2012 in the department of thoracic surgery of Zaporizhzhia Regional Clinical Oncologic Dispensary. In order to identify the factors connected with the risks of low survival rate of patients with the early stage of non-small cell lung cancer after curative treatment (surgical treatment, adjuvant chemotherapy), a method of design of neural network models of classification was used. 39 factors were taken for input characteristics. During investigation two forecasting models were built. As follows from the analysis of first forecasting model with the increase of the patient’s BMI, the risk of low patient survival rate statistically and significantly (p = 0.03) decreases, OR = 0.89 (95% CI 0.80 - 0.99) for each kg/m2 index value. The risk of low patient survival rate also decreases (p = 0.02) if he has a squamous cell carcinoma, OR = 0.36 (95% CI 0.15 - 0.88) compared with other histological forms of tumor. The connection between the risk of low patient survival rate and the volume of surgical intervention was discovered (p = 0.01), OR = 3.19 (95% CI 1.29 - 7.86) for patients who underwent a pulmonectomy compared with patients who underwent an upper bilobectomy. As follows from the analysis of second forecasting model with the increase of the patient’s BMI the risk of low patient survival rate statistically and significantly (p = 0.01) decreases;OR = 0.84 (95% CI 0.74 - 0.96) for each kg/m2 index value. It is found that with the increasing level of EGFR expression in the primary tumor, the risk of low patient survival rate statistically and significantly increases (p = 0.04), OR = 1.39 (95% CI 1.01 - 1.90) for each graduation rate. The risk of low patient survival rate also increases when conducting the lymph dissection in the volume D0 - D1.