Survival in operable non-small-cell lung cancer: Role of p53 mutations, tobacco smoking and asbestos exposure

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Abstract
Validated markers are needed to identify operable lung cancer patients with poor prognosis. About one‐half of non‐small‐cell lung cancers (NSCLCs) carry a mutation in the p53 tumor‐suppressor gene. We examined 101 NSCLC patients for surgical stage, completeness of resection, tobacco smoking, asbestos exposure, age, gender and p53 gene mutations as prognostic factors after a follow‐up period of 4 years. Cox`s multivariate regression model was applied to quantify the associations with overall and cancer‐related survival. Patients with a wild‐type p53 gene had an overall 4‐year survival of 43% and those with a mutated p53 gene, 35%. In squamous‐cell carcinoma, stage and heavy smoking, defined as the median of pack‐years smoked, had prognostic significance for overall survival. Only stage was associated with poor cancer‐related survival. Asbestos exposure was not associated with overall survival or cancer‐related survival in squamous‐cell carcinoma or adenocarcinoma. In adenocarcinoma, p53 mutation, in addition to stage, emerged as a significant predictor of poor cancer‐related survival. Int. J. Cancer 86:590–594, 2000.