ArticleAmerican journal of cancer research2026
Analysis of influencing factors of recurrence after thoracoscopic resection in patients with Stage I a lung adenocarcinoma.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study aimed to investigate the influencing factors of recurrence after thoracoscopic resection in patients with Stage I a lung adenocarcinoma. The derivation cohort consisted of 104 patients admitted between February 2020 and December 2021, categorized into recurrence (n = 39) and non-recurrence (n = 65) groups based on postoperative recurrence status. Internal validation was performed using 10-fold cross-validation. Additionally, a temporally distinct validation cohort of 80 patients admitted between January 2022 and April 2022 was used for external validation, with similar recurrence-based grouping (relapse: n = 30; non-recurrent: n = 50). Univariate analysis revealed significant differences in age, maximum tumor diameter, pleural invasion, tumor differentiation, number of lymph node dissections, comorbidities, family history, and smoking history (P<0.05). Postoperative levels of platelet/lymphocyte count ratio (PLR), carcinoembryonic antigen (CEA), and Cytokeratin 19 Fragment (Cyfra21-1) were significantly lower in the non-recurrence group (P<0.05). Multivariate logistic regression and Cox proportional hazards regression analyses were performed to account for both categorical recurrence outcome and time-to-event data. Both models consistently identified maximum tumor diameter (logistic OR = 2.300, Cox HR = 2.119), tumor differentiation (OR = 2.333, HR = 2.251), number of lymph node dissections (OR = 2.782, HR = 2.581), and pleural invasion (OR = 1.394, HR = 1.411) as independent risk factors for recurrence (all P<0.05). The combined predictive model incorporating these four factors achieved an AUC of 0.924 (P<0.001), with sensitivity of 87.2% and specificity of 86.2%. The model was further validated in an independent external cohort (n = 80), showing an AUC of 0.940. In conclusion, a model integrating maximum tumor diameter, tumor differentiation, number of lymph node dissections, and pleural invasion effectively predicts recurrence risk after thoracoscopic resection in Stage I a lung adenocarcinoma, facilitating individualized treatment planning.
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