Online ISSN: 2149-3189
2015
Monthly
Nicaea Medical Publishing
Türkiye

Prognostic factors and the impact of adjuvant chemotherapy on recurrence and survival in stage I non-small cell lung cancer: A real-world study

Akif Doğan, Sedat Yıldırım, Hande Nur Erölmez, Goncagül Akdağ, Zeynep Yüksel Yaşar, Ezgi Türkoğlu, Nurullah İlhan, Seval Ay Ersoy
  • Akif Doğan (Author) Department of Medical Oncology, University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Türkiye https://orcid.org/0000-0003-4275-2414
  • Sedat Yıldırım (Author) Department of Medical Oncology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye https://orcid.org/0000-0002-2423-6902
  • Hande Nur Erölmez (Author) Department of Family Medicine, University of Health Sciences, Sancaktepe, Şehit Prof Dr. İlhan Varank Training Research Hospital, İstanbul, Türkiye https://orcid.org/0009-0004-3791-9157
  • Goncagül Akdağ (Author) Department of Medical Oncology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye https://orcid.org/0000-0002-6221-0623
  • Zeynep Yüksel Yaşar (Author) Department of Medical Oncology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye https://orcid.org/0000-0002-2929-5039
  • Ezgi Türkoğlu (Author) Department of Medical Oncology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye https://orcid.org/0000-0003-3846-7047
  • Nurullah İlhan (Author) Department of Medical Oncology, University of Health Sciences, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Türkiye https://orcid.org/0000-0001-9908-9284
  • Seval Ay Ersoy (Author) Department of Medical Oncology, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Türkiye https://orcid.org/0000-0002-7555-2657
DOI
https://doi.org/10.18621/eurj.1633305
Abstract
Objectives: Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality. Despite curative surgery, recurrence is common in Stage I NSCLC, highlighting the need for improved prognostic classification. This study aims to evaluate the key pathological factors affecting recurrence and survival and to investigate the potential benefit of adjuvant chemotherapy (ACT) in patients with Stage I NSCLC.
Methods: A retrospective analysis was conducted on patients with Stage I NSCLC who underwent curative surgery between 2010 and 2024. Demographic and disease-related prognostic factors were assessed. The impact of these factors, along with adjuvant chemotherapy (ACT), on overall survival (OS) and disease-free survival (DFS) was analyzed.
Results: A total of 95 patients were included in the study, with a median follow-up period of 47 months. Recurrence occurred in 35.8% of patients, and 16.8% died. The five-year OS and DFS rates were calculated as 76.4% and 67.9%, respectively. Spread through air spaces (STAS) was identified as an independent prognostic factor associated with an increased risk of recurrence. While OS was shorter in patients with LVI positivity, it was not determined to be an independent prognostic factor. Visceral pleural invasion (VPI) did not demonstrate a significant prognostic impact on survival or recurrence. The effect of ACT on OS and DFS was evaluated, but no survival advantage was observed.
Conclusions: Certain pathological factors influence survival and recurrence in Stage I NSCLC. While STAS was identified as an independent prognostic factor, ACT did not provide a significant benefit for OS or DFS. These findings emphasize the importance of individualized treatment approaches and close oncological follow-up after surgery. Future studies should incorporate novel and effective biomarkers, such as circulating tumor DNA, to optimize adjuvant therapy decisions.
Keywords
Non-small cell lung cancer, spread through air spaces, recurrence, survival, prognostic factors, lymphovascular invasion, adjuvant chemotherapy
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How to Cite
1.
Doğan A, Yıldırım S, Erölmez HN, et al. Prognostic factors and the impact of adjuvant chemotherapy on recurrence and survival in stage I non-small cell lung cancer: A real-world study. Eur Res J. 2025;11(2):351-362. doi:10.18621/eurj.1633305
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  • Article Type Research Article
  • Submitted February 21, 2026
  • Published March 3, 2025
  • Issue Vol. 11 No. 2 (2025)
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