There is a greater representation of African Americans, Asians or Pacific Islanders, women, and adenocarcinoma histology in the younger cohort of patients with NSCLC compared with the older cohort. Despite presenting with stage IV disease more often, the overall and cancer-specific survivals are better in younger cohort than in the older cohort.
About 30% stage I non-small cell lung cancer (NSCLC) patients undergoing resection will recur. Robust prognostic markers are required to better manage therapy options. MicroRNAs (miRNAs) are a class of small non-coding RNAs of 19-25 nt and play important roles in gene regulation in human cancers. The purpose of this study is to identify miRNA expression profiles that would better predict prognosis of stage I NSCLC. MiRNAs extracted from 527 stage I NSCLC patients were profiled on the human miRNA expression profiling v2 panel (Illumina). The expression profiles were analyzed for their association with cancer subtypes, lung cancer brain metastasis and recurrence/relapse free survival (RFS). MiRNA expression patterns between lung adenocarcinoma and squamous cell carcinoma differed significantly with 171 miRNAs, including Let-7 family members and miR-205. Ten miRNAs associated with brain metastasis were identified including miR-145*, which inhibit cell invasion and metastasis. Two miRNA signatures that are highly predictive of RFS were identified. The first contained 34 miRNAs derived from 357 stage I NSCLC patients independent of cancer subtype, whereas the second containing 27 miRNAs was adenocarcinoma specific. Both signatures were validated using formalin-fixed paraffin embedded and/or fresh frozen tissues in independent data set with 170 stage I patients. Our findings have important prognostic or therapeutic implications for the management of stage I lung cancer patients. The identified miRNAs hold great potential as targets for histology-specific treatment or prevention and treatment of recurrent disease.
7598 Background: We have previously reported a significant change in stage distribution for non-small cell lung cancer (NSCLC) among patients diagnosed at our institution (ASCO 2006 # 7205). To confirm this observation, a larger sample population was evaluated. Methods: Patients with NSCLC registered at the National Cancer Database (NCDB) and diagnosed between the years 1998 and 2003 were evaluated for demographic characteristics including age, race, gender, and stage at presentation. Results: 551,248 patients were identified. Patients with stage 0 or unknown stage were excluded from the study, leaving 510,942 eligible for the final analysis. The annual proportions of stage IV disease at the time of diagnosis are described in the table below. Stage distribution remained stable from 1998 to 2000, but a sharp increase in the percentage of stage IV was noticed between 2000 and 2001 (35.7% to 38.9%). This increase in the percentage of stage IV patients was sustained in the subsequent years and present across the other demographic variables. Conclusions: We have documented a significant change in the NSCLC stage distribution over the last six years. The NCDB is the largest database available and currently captures approximately 62% of all NSCLC patients diagnosed in the United States. The increase in stage IV disease coincides with the widespread adoption of FDG-PET, suggesting an earlier diagnosis of metastatic disease and confirming our previous findings. No significant financial relationships to disclose. [Table: see text]
High SUVmax (>or=5.5) on preoperative FDG-PET is an independent predictor of relapse and death in resected stage I NSCLC. Prospective trials of adjuvant chemotherapy in patients with stage I NSCLC and high SUVmax should be considered.
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