Survival and prognostic factors affecting survival in early stage lung cancer undergoing lung resection

Introduction: The most effective treatment for lung cancer, which is the most lethal cancer in the world and in our country, is complete excision without leaving the tumor behind It is crucial to diagnose the disease at an early stage, as only 25% of patients are suitable for surgical treatment at diagnosis. This becomes even more critical because the curative operability rate and survival rate are lower in the advanced stage. Our goal is to uncover the impact of preoperative, intraoperative, and postoperative changes on disease prognosis to improve treatment management for early-stage patients. Material and methods: In this study, we analyzed the data of patients with early- stage lung cancer who underwent complete excision at the Department of Thoracic Surgery of İnönü University Faculty of Medicine between 2012-2021. The histopathological diagnosis of each patient was taken into consideration, and survival analyses were conducted based on various factors. The results of this study provide valuable insights into the prognosis of early-stage lung cancer patients who undergo surgery. Results: The mean survival time of the patients was 110.39 months and the overall survival was 84.3%. Presence of preoperative dyspnea (p=0.003), male gender (p=0.044), patients over 65 years of age (p=0.002), preference for thoracotomy as a surgical procedure (p=0.043), complete fissure (p=0.016), intraoperative presence of complications (p<0.001), pathology of squamous ca (p=0.021), presence of lymphovascular invasion (p=0.019), Stage 1B (T2A) (p=0.031), receiving chemotherapy in the postoperative period (p=0.008), postoperative period In the follow-ups, bone metastasis (p<0.001) was found to be significant on survival. In the regression analysis made with these factors; Presence of dyspnea, age, thoracotomy preference, intraoperative complication, pathology, squamous ca, presence of lymphovascular invasion were found as independent negative prognostic factors on survival. Conclusion: For early-stage lung cancer, the most effective treatment involves complete anatomical resections combined with lymph node dissection. While sublobar resections may be considered for patients with advanced age, increased comorbidities, and poor performance, the preferred option is usually the lobectomy procedure. The use of minimally invasive surgical methods has resulted in statistically significant differences in patient survival compared to thoracotomy. Keywords: Lung cancer, stage 1A-1B, early stage, resection, survival