Kolesnik O. Improvement of surgical and combined treatment of patients with lung cancer stages I II and the development of methods for the prediction of disease outcome

The risk of lung cancer progression after surgical treatment is affected by the criterion of T, N, volume of surgical operation, molecular properties of the tumor (Ki-67, CD31, Her-2/neu, EGFR). Although, the risk of lung cancer progression after combined therapy is affected with location, histological forms, grade of morphological differentiation of the tumor, criterion T, N, presence of Ki-67, p53, Her-2/neu, EGFR, E-cadherin-positive immunohistochemical reaction in tumor cells. An important predictor is the presence of cytokeratin-positive cells (CPC) in the lymph nodes of the hilar of the lung. In the presence of CPC in the hilar lymph nodes, local recurrence was detected 18,1 % more than in the absence of CPC (p < 0.05). Improved technique of performance complete lymph nodes dissection reduces the time of operation, the volume of intra-operative blood loss and complications. Complete lymph nodes dissection for patients with lung cancer stages I II can reduce the disease progression. Conducting adjuvant chemotherapy reduces the occurrence of disease progression on 4,2 % in stage I lung cancer patients and 22,0 % in stage II lung cancer patients compared with patients who underwent surgery alone. Markers of efficiency adjuvant chemotherapy were Ki-67, p53, CD31, Her-2/neu. Using Cox-regression and score prediction models allow with high probability to predict the progression in lung cancer patients after surgical and combined therapy. It was improved algorithm for the treatment of patients with non-small cell lung cancer stage I II on base of determining the indications for complete lymph nodes dissection, conduct adjuvant chemotherapy and predict disease outcome.