Abstract 208P
Background
5-survival (5YS) and life span after radical surgery for non-small cell lung cancer (LC) patients (LCP) (T1-4N0-2M0) was analyzed.
Methods
We analyzed data of 771 consecutive LCP (age = 57.6 ± 8.3 years) radically operated and monitored in 1985–2022 (m = 662, f = 109; lobectomies = 516, pneumonectomies = 255; combined procedures = 194; only surgery-S = 620, adjuvant chemoimmunoradiotherapy-AT = 151: CAV/gemcitabine+cisplatin+thymalin/taktivin+radiotherapy 45–50 Gy; T1 = 322, T2 = 255, T3 = 133, T4 = 61; N0 = 518, N1 = 131, N2 = 122, M0 = 771; squamous = 418, adenocarcinoma = 303, large cell = 50; early LC = 215, invasive LC = 556. Variables selected for study were input levels of 45 blood parameters, sex, age, TNMG, cell type, tumor size. Regression, clustering, SEPATH, Monte Carlo, bootstrap, neural networks were used to determine significant dependence.
Results
Overall life span (LS) was 2240.9 ± 1748.8 days and 5-year survival (5YS) reached 73%, 10 years – 64.2%, 20 years – 43%. 503 LCP lived more than 5 years (LS = 3126.6 ± 1536 days), 145 LCP – more than 10 years (LS = 5068.5 ± 1513.2 days).199 LCP died because of LC (LS = 562.7 ± 374.5 days). 5YS of LCP after lobectomies was significantly superior in comparison with LCP after pneumonectomies (77.7% vs. 63.4%, P = 0.00001). AT significantly improved 5YS (64.4% vs. 34.8%) (P = 0.00003 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P = 0.000–0.035). Neural networks, bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank = 1), PT N0–N12 (rank = 2), thrombocytes/CC, eosinophils/CC, erythrocytes/CC, healthy cells/CC, segmented neutrophils/CC, lymphocytes, stick neutrophils/CC, monocytes/CC; leucocytes/CC. Correct prediction of 5YS was 100% by neural networks computing.
Conclusions
5YS of LCP after radical procedures significantly depended on: PT early-invasive cancer; PT N0--N12; cell ratio factors; blood cell circuit; biochemical factors; hemostasis system; AT; LC characteristics; surgery type; LC cell dynamics; anthropometric data.
Legal entity responsible for the study
O. Kshivets.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.