Prognostic significance of tumor proliferative fraction and DNA content in stage I non-small cell lung cancer

A. E. Filderman, G. A. Silvestri, C. Gatsonis, D. J. Luthringer, J. Honig, Stuart D Flynn

Research output: Contribution to journalArticle

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Abstract

Analyses of tumor DNA content and proliferative fraction by flow cytometry have been useful as prognostic determinants in a variety of solid tumors. The significance of this analysis in Stage I (T1N0M0 and T2N0M0) non-small cell lung carcinoma (NSCC) is unestablished. We determined DNA content (ploidy) and proliferative fraction (percentage S phase) on 44 surgically resected Stage I NSCC specimens obtained between 1977 and 1982. All cases had a minimum follow-up of 5 yr. Of the 44 cases, 27 were adenocarcinomas, 15 squamous cell carcinomas, and 2 large cell carcinomas. Of these, 32 (73%) had T1N0M0 lesions and 12 (27%) had T2N0M0 lesions. Overall 5-yr survival was 70%. All patients surviving 5 yr were free of detectable tumor. Patients with T1N0M0 lesions had an 81% 5-yr survival, but those with T2N0M0 lesions had a 42% 5-yr survival (p = 0.009). Analysis of tumor DNA content revealed 35 diploid tumors (79%) and 9 aneuploid tumors (21%). The 5-yr survival for diploid tumors was 77% compared with a 44% 5-yr survival in aneuploid lesions (p = 0.048). The median proliferative fraction was 6%. All patients with a percentage S phase less than 6% survived 5 yr, and 41% (9 of 22) of those greater than 6% survived 5 yr (p < 0.001). When 8% S phase was used as a cutoff, 93% (28 of 30) below the cutoff survived 5 yr but only 21% (3 of 14) above the cutoff survived 5 yr (p < 0.001). Within the T1N0M0 subgroup (n = 32), all patients with a percentage S phase less than 6% survived past 5 yr but only 54% (7 of 13) of those greater than 6% survived 5 yr (p = 0.002). Thus, measurement of tumor proliferative fraction and, to a lesser extent DNA content, in Stage I NSCC may provide significant prognostic information apart from TNM stage and help identify a subset of patients at high risk for tumor relapse.

Original languageEnglish (US)
Pages (from-to)707-710
Number of pages4
JournalAmerican Review of Respiratory Disease
Volume146
Issue number3
StatePublished - 1992
Externally publishedYes

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Non-Small Cell Lung Carcinoma
DNA
S Phase
Neoplasms
Survival
Aneuploidy
Diploidy
Large Cell Carcinoma
Ploidies
Squamous Cell Carcinoma
Flow Cytometry
Adenocarcinoma
Recurrence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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Prognostic significance of tumor proliferative fraction and DNA content in stage I non-small cell lung cancer. / Filderman, A. E.; Silvestri, G. A.; Gatsonis, C.; Luthringer, D. J.; Honig, J.; Flynn, Stuart D.

In: American Review of Respiratory Disease, Vol. 146, No. 3, 1992, p. 707-710.

Research output: Contribution to journalArticle

Filderman, AE, Silvestri, GA, Gatsonis, C, Luthringer, DJ, Honig, J & Flynn, SD 1992, 'Prognostic significance of tumor proliferative fraction and DNA content in stage I non-small cell lung cancer', American Review of Respiratory Disease, vol. 146, no. 3, pp. 707-710.
Filderman, A. E. ; Silvestri, G. A. ; Gatsonis, C. ; Luthringer, D. J. ; Honig, J. ; Flynn, Stuart D. / Prognostic significance of tumor proliferative fraction and DNA content in stage I non-small cell lung cancer. In: American Review of Respiratory Disease. 1992 ; Vol. 146, No. 3. pp. 707-710.
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AU - Luthringer, D. J.

AU - Honig, J.

AU - Flynn, Stuart D

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N2 - Analyses of tumor DNA content and proliferative fraction by flow cytometry have been useful as prognostic determinants in a variety of solid tumors. The significance of this analysis in Stage I (T1N0M0 and T2N0M0) non-small cell lung carcinoma (NSCC) is unestablished. We determined DNA content (ploidy) and proliferative fraction (percentage S phase) on 44 surgically resected Stage I NSCC specimens obtained between 1977 and 1982. All cases had a minimum follow-up of 5 yr. Of the 44 cases, 27 were adenocarcinomas, 15 squamous cell carcinomas, and 2 large cell carcinomas. Of these, 32 (73%) had T1N0M0 lesions and 12 (27%) had T2N0M0 lesions. Overall 5-yr survival was 70%. All patients surviving 5 yr were free of detectable tumor. Patients with T1N0M0 lesions had an 81% 5-yr survival, but those with T2N0M0 lesions had a 42% 5-yr survival (p = 0.009). Analysis of tumor DNA content revealed 35 diploid tumors (79%) and 9 aneuploid tumors (21%). The 5-yr survival for diploid tumors was 77% compared with a 44% 5-yr survival in aneuploid lesions (p = 0.048). The median proliferative fraction was 6%. All patients with a percentage S phase less than 6% survived 5 yr, and 41% (9 of 22) of those greater than 6% survived 5 yr (p < 0.001). When 8% S phase was used as a cutoff, 93% (28 of 30) below the cutoff survived 5 yr but only 21% (3 of 14) above the cutoff survived 5 yr (p < 0.001). Within the T1N0M0 subgroup (n = 32), all patients with a percentage S phase less than 6% survived past 5 yr but only 54% (7 of 13) of those greater than 6% survived 5 yr (p = 0.002). Thus, measurement of tumor proliferative fraction and, to a lesser extent DNA content, in Stage I NSCC may provide significant prognostic information apart from TNM stage and help identify a subset of patients at high risk for tumor relapse.

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