PURPOSE: To retrospectively construct a comprehensive multivariate model of @entity5 recurrence and to design a molecular pathologic substaging system in stage I @entity1149 ( @entity1149 ). METHODS: All @entity1 with stage I @entity1149 resected at Brigham and @entity1 's Hospital (Boston, MA) between 1984 and 1992 with adequate clinical follow-up were studied. The importance of three demographic characteristics, surgical extent, 11 pathologic features, and seven molecular factors on @entity5 -free survival was examined. RESULTS: Two hundred forty-four @entity1 were studied, with 25 noncancer deaths and 80 @entity1 with recurrent disease. Significant univariate predictors (P < .05) of @entity5 recurrence were age older than 60 years, male sex, wedge resection, World Health Organization (WHO) @entity420 subtype @entity5 with @entity3558 , lymphatic invasion, and @entity876 expression. Multivariate analysis identified nine independent predictors of recurrence: @entity5 with @entity3558 , a wedge resection, @entity5 diameter of 4 cm or greater, lymphatic invasion, age older than 60 years, male sex, @entity876 expression, @entity984 codon 12 mutation, and absence of H-ras @entity3544 expression. Multivariate @entity5 -free survival (CFS) analysis in the 180 @entity1 who underwent lobectomy or pneumonectomy led to the elimination of sex and age, which left six independent factors. CONCLUSION: Lobectomy or pneumonectomy should be performed in stage I @entity1149 . Using the six independent factors for recurrent disease, we propose a pathologic molecular substaging system. @entity1 with two factors or less are graded Ia, with a 5-year CFS rate of 87%; those with three factors are graded Ib, with a 5-year CFS rate of 58%; and those with four factors or more are graded Ic, with a 5-year CFS rate of 21%.

Molecular pathologic substaging in 244 stage I @entity1149 XXXX : clinical implications.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'Women'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'solid tumor', 'cancer'] @entity984 :: ('3845', 'Gene') :: ['K-ras'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small-cell lung cancer'] @entity3544 :: ('644914', 'Gene') :: ['p21'] @entity876 :: ('7157', 'Gene') :: ['p53'] @entity3558 :: ('100508689', 'Gene') :: ['mucin'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma']
@entity1 :: (9606,Species) :: ['patients']
