Non-small cell lung cancer: 10-year survival after surgery

Objective: 10-Year survival (10YS) after radical surgery for non-small cell lung cancer (LC) pa­tients (LCP) (T1-4N0-2M0) was analyzed. Methods: We analyzed data of 768 consecutive LCP (age=57.6±8.3 years; tumor size=4.1±2.4 cm) radically operated (R0) and monitored in 1985-2021 (m=660, f=108; upper lobectomies=277, lower lobectomies=177, middle lobectomies=18, bilobectomies=42, pneumonectomies=254, mediastinal lymph node dissection=768; combined procedures with resection trachea, carina, atrium, aorta, VCS, vena azygos, pericardium, liver, diaphragm, ribs, esophagus=193; only surgery-S=618, adjuvant chemoimmunoradiotherapy-AT=150: CAV/gemzar + cisplatin thymalin/taktivin radiotherapy 45-50Gy; T1=320, T2=255, T3=133, T4=60; N0=516, N1=131, N2=121, M0=768; G1=194, G2=243, G3=331; squamous=417, adenocarcinoma=301, large cell=50; early LC=214, invasive LC=554; right LC=412, left LC=356; central=290; peripheral=478. Variables selected 10YS study were input levels 45 blood parameters, sex, age, TNMG, type, size. Survival curves estimated by the Kaplan-Meier method. Differences between groups evaluated using a log-rank test. Multivariate Cox modeling, analysis, clustering, SEPATH, Monte Carlo, bootstrap neural networks computing used to determine any significant dependence. Results: Overall life span (LS) 2244.9±1750.3 days cumulative 5-year (5YS) reached 72.9%, 10 years – 64.3%, 20 43.1%. 502 lived more than 5 (LS=3128.7±1536.8 days), 145 (LS=5068.5±1513.2 days).199 died because LC (LS=562.7±374.5 days). AT significantly improved (52.4% vs. 27.7%) (P=0.00002 test) N1-2. modeling displayed that depended on: phase transition (PT) early-invasive terms synergetics, PT N0—N12, ratio factors (ratio cells- CC cells subpopulations), G1-3, histology, glucose, AT, circuit, prothrombin index, heparin tolerance, recalcification time, weight, color index (P=0.000-0.039). Neural networks, genetic algorithm selection simulation revealed relationships (rank=1), thrombocytes/CC (rank=2), N0—N12(rank=3), segmented neutrophils/CC (4), healthy cells/CC (5), lymphocytes/CC (6), erythrocytes/CC (7), stick (8), eosinophils/CC (9), leucocytes/CC (10), monocytes/CC (11). Correct prediction 5YS 100% (area under ROC curve=1.0; error=0.0). Conclusions: 1) cancer; 2) N0--N12; 3) factors; 4) circuit; 5) biochemical 6) hemostasis system; 7) AT; 8) characteristics; 9) anthropometric data; 10) type. Optimal diagnosis treatment strategies are: screening detection LC; availability experienced thoracic surgeons complexity procedures; aggressive en block adequate dissection completeness; precise prediction; chemoimmunoradiotherapy unfavorable prognosis.