A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies
Summary Background The frequent recurrence of early-stage non-small-cell lung cancer (NSCLC) is generally attributable to metastatic disease undetected at complete resection. Management of such patients depends on prognostic staging to identify the individuals most likely to have occult disease. We...
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| Veröffentlicht in: | The Lancet (British edition) 2012-03, Vol.379 (9818), p.823-832 |
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| creator | Kratz, Johannes R, MD He, Jianxing, Prof Van Den Eeden, Stephen K, PhD Zhu, Zhi-Hua, Prof Gao, Wen, Prof Pham, Patrick T, BS Mulvihill, Michael S, BS Ziaei, Fatemeh, BS Zhang, Huanrong, MD Su, Bo, MD Zhi, Xiuyi, Prof Quesenberry, Charles P, PhD Habel, Laurel A, BS Deng, Qiuhua, BS Wang, Zongfei, BS Zhou, Jiangfen, BS Li, Huiling, PhD Huang, Mei-Chun, PhD Yeh, Che-Chung, PhD Segal, Mark R, Prof Ray, M Roshni, BS Jones, Kirk D, Prof Raz, Dan J, MD Xu, Zhidong, MD Jahan, Thierry M, MD Berryman, David, PharmD He, Biao, PhD Mann, Michael J, Dr Jablons, David M, Prof |
| description | Summary Background The frequent recurrence of early-stage non-small-cell lung cancer (NSCLC) is generally attributable to metastatic disease undetected at complete resection. Management of such patients depends on prognostic staging to identify the individuals most likely to have occult disease. We aimed to develop and validate a practical, reliable assay that improves risk stratification compared with conventional staging. Methods A 14-gene expression assay that uses quantitative PCR, runs on formalin-fixed paraffin-embedded tissue samples, and differentiates patients with heterogeneous statistical prognoses was developed in a cohort of 361 patients with non-squamous NSCLC resected at the University of California, San Francisco. The assay was then independently validated by the Kaiser Permanente Division of Research in a masked cohort of 433 patients with stage I non-squamous NSCLC resected at Kaiser Permanente Northern California hospitals, and on a cohort of 1006 patients with stage I–III non-squamous NSCLC resected in several leading Chinese cancer centres that are part of the China Clinical Trials Consortium (CCTC). Findings Kaplan-Meier analysis of the Kaiser validation cohort showed 5 year overall survival of 71·4% (95% CI 60·5–80·0) in low-risk, 58·3% (48·9–66·6) in intermediate-risk, and 49·2% (42·2–55·8) in high-risk patients (ptrend =0·0003). Similar analysis of the CCTC cohort indicated 5 year overall survivals of 74·1% (66·0–80·6) in low-risk, 57·4% (48·3–65·5) in intermediate-risk, and 44·6% (40·2–48·9) in high-risk patients (ptrend |
| doi_str_mv | 10.1016/S0140-6736(11)61941-7 |
| format | Article |
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Management of such patients depends on prognostic staging to identify the individuals most likely to have occult disease. We aimed to develop and validate a practical, reliable assay that improves risk stratification compared with conventional staging. Methods A 14-gene expression assay that uses quantitative PCR, runs on formalin-fixed paraffin-embedded tissue samples, and differentiates patients with heterogeneous statistical prognoses was developed in a cohort of 361 patients with non-squamous NSCLC resected at the University of California, San Francisco. The assay was then independently validated by the Kaiser Permanente Division of Research in a masked cohort of 433 patients with stage I non-squamous NSCLC resected at Kaiser Permanente Northern California hospitals, and on a cohort of 1006 patients with stage I–III non-squamous NSCLC resected in several leading Chinese cancer centres that are part of the China Clinical Trials Consortium (CCTC). Findings Kaplan-Meier analysis of the Kaiser validation cohort showed 5 year overall survival of 71·4% (95% CI 60·5–80·0) in low-risk, 58·3% (48·9–66·6) in intermediate-risk, and 49·2% (42·2–55·8) in high-risk patients (ptrend =0·0003). Similar analysis of the CCTC cohort indicated 5 year overall survivals of 74·1% (66·0–80·6) in low-risk, 57·4% (48·3–65·5) in intermediate-risk, and 44·6% (40·2–48·9) in high-risk patients (ptrend <0·0001). Multivariate analysis in both cohorts indicated that no standard clinical risk factors could account for, or provide, the prognostic information derived from tumour gene expression. The assay improved prognostic accuracy beyond National Comprehensive Cancer Network criteria for stage I high-risk tumours (p<0·0001), and differentiated low-risk, intermediate-risk, and high-risk patients within all disease stages. Interpretation Our practical, quantitative-PCR-based assay reliably identified patients with early-stage non-squamous NSCLC at high risk for mortality after surgical resection. Funding UCSF Thoracic Oncology Laboratory and Pinpoint Genomics.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(11)61941-7</identifier><identifier>PMID: 22285053</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Adult ; Aged ; Biological and medical sciences ; California - epidemiology ; Cancer therapies ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Clinical medicine ; Clinical trials ; Colleges & universities ; Female ; Gene expression ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; General aspects ; genomics ; Hospitals ; Humans ; Internal Medicine ; International Cooperation ; Kaplan-Meier Estimate ; Lung cancer ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; Male ; Medical sciences ; Metastases ; Middle Aged ; Mortality ; Mortality risk ; Multivariate Analysis ; Neoplasm Staging ; Oncology ; Pathology ; Pneumology ; Polymerase Chain Reaction ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Review boards ; Risk Assessment ; Risk factors ; Risk groups ; Statistics ; Survival ; Thorax ; Tumors of the respiratory system and mediastinum</subject><ispartof>The Lancet (British edition), 2012-03, Vol.379 (9818), p.823-832</ispartof><rights>Elsevier Ltd</rights><rights>2012 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Mar 3-Mar 9, 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c729t-6acf84f5a23880cb2adad526611c1b5a2dc7ec11742cae82603f2a683fcc86033</citedby><cites>FETCH-LOGICAL-c729t-6acf84f5a23880cb2adad526611c1b5a2dc7ec11742cae82603f2a683fcc86033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0140673611619417$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25556877$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22285053$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kratz, Johannes R, MD</creatorcontrib><creatorcontrib>He, Jianxing, Prof</creatorcontrib><creatorcontrib>Van Den Eeden, Stephen K, PhD</creatorcontrib><creatorcontrib>Zhu, Zhi-Hua, Prof</creatorcontrib><creatorcontrib>Gao, Wen, Prof</creatorcontrib><creatorcontrib>Pham, Patrick T, BS</creatorcontrib><creatorcontrib>Mulvihill, Michael S, BS</creatorcontrib><creatorcontrib>Ziaei, Fatemeh, BS</creatorcontrib><creatorcontrib>Zhang, Huanrong, MD</creatorcontrib><creatorcontrib>Su, Bo, MD</creatorcontrib><creatorcontrib>Zhi, Xiuyi, Prof</creatorcontrib><creatorcontrib>Quesenberry, Charles P, PhD</creatorcontrib><creatorcontrib>Habel, Laurel A, BS</creatorcontrib><creatorcontrib>Deng, Qiuhua, BS</creatorcontrib><creatorcontrib>Wang, Zongfei, BS</creatorcontrib><creatorcontrib>Zhou, Jiangfen, BS</creatorcontrib><creatorcontrib>Li, Huiling, PhD</creatorcontrib><creatorcontrib>Huang, Mei-Chun, PhD</creatorcontrib><creatorcontrib>Yeh, Che-Chung, PhD</creatorcontrib><creatorcontrib>Segal, Mark R, Prof</creatorcontrib><creatorcontrib>Ray, M Roshni, BS</creatorcontrib><creatorcontrib>Jones, Kirk D, Prof</creatorcontrib><creatorcontrib>Raz, Dan J, MD</creatorcontrib><creatorcontrib>Xu, Zhidong, MD</creatorcontrib><creatorcontrib>Jahan, Thierry M, MD</creatorcontrib><creatorcontrib>Berryman, David, PharmD</creatorcontrib><creatorcontrib>He, Biao, PhD</creatorcontrib><creatorcontrib>Mann, Michael J, Dr</creatorcontrib><creatorcontrib>Jablons, David M, Prof</creatorcontrib><title>A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary Background The frequent recurrence of early-stage non-small-cell lung cancer (NSCLC) is generally attributable to metastatic disease undetected at complete resection. Management of such patients depends on prognostic staging to identify the individuals most likely to have occult disease. We aimed to develop and validate a practical, reliable assay that improves risk stratification compared with conventional staging. Methods A 14-gene expression assay that uses quantitative PCR, runs on formalin-fixed paraffin-embedded tissue samples, and differentiates patients with heterogeneous statistical prognoses was developed in a cohort of 361 patients with non-squamous NSCLC resected at the University of California, San Francisco. The assay was then independently validated by the Kaiser Permanente Division of Research in a masked cohort of 433 patients with stage I non-squamous NSCLC resected at Kaiser Permanente Northern California hospitals, and on a cohort of 1006 patients with stage I–III non-squamous NSCLC resected in several leading Chinese cancer centres that are part of the China Clinical Trials Consortium (CCTC). Findings Kaplan-Meier analysis of the Kaiser validation cohort showed 5 year overall survival of 71·4% (95% CI 60·5–80·0) in low-risk, 58·3% (48·9–66·6) in intermediate-risk, and 49·2% (42·2–55·8) in high-risk patients (ptrend =0·0003). Similar analysis of the CCTC cohort indicated 5 year overall survivals of 74·1% (66·0–80·6) in low-risk, 57·4% (48·3–65·5) in intermediate-risk, and 44·6% (40·2–48·9) in high-risk patients (ptrend <0·0001). Multivariate analysis in both cohorts indicated that no standard clinical risk factors could account for, or provide, the prognostic information derived from tumour gene expression. The assay improved prognostic accuracy beyond National Comprehensive Cancer Network criteria for stage I high-risk tumours (p<0·0001), and differentiated low-risk, intermediate-risk, and high-risk patients within all disease stages. Interpretation Our practical, quantitative-PCR-based assay reliably identified patients with early-stage non-squamous NSCLC at high risk for mortality after surgical resection. Funding UCSF Thoracic Oncology Laboratory and Pinpoint Genomics.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>California - epidemiology</subject><subject>Cancer therapies</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Clinical medicine</subject><subject>Clinical trials</subject><subject>Colleges & universities</subject><subject>Female</subject><subject>Gene expression</subject><subject>Gene Expression Profiling</subject><subject>Gene Expression Regulation, Neoplastic</subject><subject>General aspects</subject><subject>genomics</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>International Cooperation</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Mortality risk</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Pathology</subject><subject>Pneumology</subject><subject>Polymerase Chain Reaction</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Review boards</subject><subject>Risk Assessment</subject><subject>Risk factors</subject><subject>Risk groups</subject><subject>Statistics</subject><subject>Survival</subject><subject>Thorax</subject><subject>Tumors of the respiratory system and 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practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies</title><author>Kratz, Johannes R, MD ; He, Jianxing, Prof ; Van Den Eeden, Stephen K, PhD ; Zhu, Zhi-Hua, Prof ; Gao, Wen, Prof ; Pham, Patrick T, BS ; Mulvihill, Michael S, BS ; Ziaei, Fatemeh, BS ; Zhang, Huanrong, MD ; Su, Bo, MD ; Zhi, Xiuyi, Prof ; Quesenberry, Charles P, PhD ; Habel, Laurel A, BS ; Deng, Qiuhua, BS ; Wang, Zongfei, BS ; Zhou, Jiangfen, BS ; Li, Huiling, PhD ; Huang, Mei-Chun, PhD ; Yeh, Che-Chung, PhD ; Segal, Mark R, Prof ; Ray, M Roshni, BS ; Jones, Kirk D, Prof ; Raz, Dan J, MD ; Xu, Zhidong, MD ; Jahan, Thierry M, MD ; Berryman, David, PharmD ; He, Biao, PhD ; Mann, Michael J, Dr ; Jablons, David M, Prof</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c729t-6acf84f5a23880cb2adad526611c1b5a2dc7ec11742cae82603f2a683fcc86033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>California - epidemiology</topic><topic>Cancer therapies</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Clinical medicine</topic><topic>Clinical trials</topic><topic>Colleges & universities</topic><topic>Female</topic><topic>Gene expression</topic><topic>Gene Expression Profiling</topic><topic>Gene Expression Regulation, Neoplastic</topic><topic>General aspects</topic><topic>genomics</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>International Cooperation</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Mortality risk</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Pathology</topic><topic>Pneumology</topic><topic>Polymerase Chain Reaction</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Review boards</topic><topic>Risk Assessment</topic><topic>Risk factors</topic><topic>Risk groups</topic><topic>Statistics</topic><topic>Survival</topic><topic>Thorax</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kratz, Johannes R, MD</creatorcontrib><creatorcontrib>He, Jianxing, Prof</creatorcontrib><creatorcontrib>Van Den Eeden, Stephen K, PhD</creatorcontrib><creatorcontrib>Zhu, Zhi-Hua, Prof</creatorcontrib><creatorcontrib>Gao, Wen, Prof</creatorcontrib><creatorcontrib>Pham, Patrick T, BS</creatorcontrib><creatorcontrib>Mulvihill, Michael S, BS</creatorcontrib><creatorcontrib>Ziaei, Fatemeh, BS</creatorcontrib><creatorcontrib>Zhang, Huanrong, MD</creatorcontrib><creatorcontrib>Su, Bo, MD</creatorcontrib><creatorcontrib>Zhi, Xiuyi, Prof</creatorcontrib><creatorcontrib>Quesenberry, Charles P, PhD</creatorcontrib><creatorcontrib>Habel, Laurel A, BS</creatorcontrib><creatorcontrib>Deng, Qiuhua, BS</creatorcontrib><creatorcontrib>Wang, Zongfei, BS</creatorcontrib><creatorcontrib>Zhou, Jiangfen, BS</creatorcontrib><creatorcontrib>Li, Huiling, PhD</creatorcontrib><creatorcontrib>Huang, Mei-Chun, PhD</creatorcontrib><creatorcontrib>Yeh, Che-Chung, PhD</creatorcontrib><creatorcontrib>Segal, Mark R, Prof</creatorcontrib><creatorcontrib>Ray, M Roshni, BS</creatorcontrib><creatorcontrib>Jones, Kirk D, Prof</creatorcontrib><creatorcontrib>Raz, Dan J, MD</creatorcontrib><creatorcontrib>Xu, Zhidong, MD</creatorcontrib><creatorcontrib>Jahan, Thierry M, MD</creatorcontrib><creatorcontrib>Berryman, David, PharmD</creatorcontrib><creatorcontrib>He, Biao, PhD</creatorcontrib><creatorcontrib>Mann, Michael J, Dr</creatorcontrib><creatorcontrib>Jablons, David M, Prof</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>News PRO</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Global News & ABI/Inform 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Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kratz, Johannes R, MD</au><au>He, Jianxing, Prof</au><au>Van Den Eeden, Stephen K, PhD</au><au>Zhu, Zhi-Hua, Prof</au><au>Gao, Wen, Prof</au><au>Pham, Patrick T, BS</au><au>Mulvihill, Michael S, BS</au><au>Ziaei, Fatemeh, BS</au><au>Zhang, Huanrong, MD</au><au>Su, Bo, MD</au><au>Zhi, Xiuyi, Prof</au><au>Quesenberry, Charles P, PhD</au><au>Habel, Laurel A, BS</au><au>Deng, Qiuhua, BS</au><au>Wang, Zongfei, BS</au><au>Zhou, Jiangfen, BS</au><au>Li, Huiling, PhD</au><au>Huang, Mei-Chun, PhD</au><au>Yeh, Che-Chung, PhD</au><au>Segal, Mark R, Prof</au><au>Ray, M Roshni, BS</au><au>Jones, Kirk D, Prof</au><au>Raz, Dan J, MD</au><au>Xu, Zhidong, MD</au><au>Jahan, Thierry M, MD</au><au>Berryman, David, PharmD</au><au>He, Biao, PhD</au><au>Mann, Michael J, Dr</au><au>Jablons, David M, Prof</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2012-03-03</date><risdate>2012</risdate><volume>379</volume><issue>9818</issue><spage>823</spage><epage>832</epage><pages>823-832</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Summary Background The frequent recurrence of early-stage non-small-cell lung cancer (NSCLC) is generally attributable to metastatic disease undetected at complete resection. Management of such patients depends on prognostic staging to identify the individuals most likely to have occult disease. We aimed to develop and validate a practical, reliable assay that improves risk stratification compared with conventional staging. Methods A 14-gene expression assay that uses quantitative PCR, runs on formalin-fixed paraffin-embedded tissue samples, and differentiates patients with heterogeneous statistical prognoses was developed in a cohort of 361 patients with non-squamous NSCLC resected at the University of California, San Francisco. The assay was then independently validated by the Kaiser Permanente Division of Research in a masked cohort of 433 patients with stage I non-squamous NSCLC resected at Kaiser Permanente Northern California hospitals, and on a cohort of 1006 patients with stage I–III non-squamous NSCLC resected in several leading Chinese cancer centres that are part of the China Clinical Trials Consortium (CCTC). Findings Kaplan-Meier analysis of the Kaiser validation cohort showed 5 year overall survival of 71·4% (95% CI 60·5–80·0) in low-risk, 58·3% (48·9–66·6) in intermediate-risk, and 49·2% (42·2–55·8) in high-risk patients (ptrend =0·0003). Similar analysis of the CCTC cohort indicated 5 year overall survivals of 74·1% (66·0–80·6) in low-risk, 57·4% (48·3–65·5) in intermediate-risk, and 44·6% (40·2–48·9) in high-risk patients (ptrend <0·0001). Multivariate analysis in both cohorts indicated that no standard clinical risk factors could account for, or provide, the prognostic information derived from tumour gene expression. The assay improved prognostic accuracy beyond National Comprehensive Cancer Network criteria for stage I high-risk tumours (p<0·0001), and differentiated low-risk, intermediate-risk, and high-risk patients within all disease stages. Interpretation Our practical, quantitative-PCR-based assay reliably identified patients with early-stage non-squamous NSCLC at high risk for mortality after surgical resection. Funding UCSF Thoracic Oncology Laboratory and Pinpoint Genomics.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>22285053</pmid><doi>10.1016/S0140-6736(11)61941-7</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 2012-03, Vol.379 (9818), p.823-832 |
| issn | 0140-6736 1474-547X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3294002 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Aged Biological and medical sciences California - epidemiology Cancer therapies Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - surgery Clinical medicine Clinical trials Colleges & universities Female Gene expression Gene Expression Profiling Gene Expression Regulation, Neoplastic General aspects genomics Hospitals Humans Internal Medicine International Cooperation Kaplan-Meier Estimate Lung cancer Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - surgery Male Medical sciences Metastases Middle Aged Mortality Mortality risk Multivariate Analysis Neoplasm Staging Oncology Pathology Pneumology Polymerase Chain Reaction Predictive Value of Tests Prognosis Proportional Hazards Models Review boards Risk Assessment Risk factors Risk groups Statistics Survival Thorax Tumors of the respiratory system and mediastinum |
| title | A practical molecular assay to predict survival in resected non-squamous, non-small-cell lung cancer: development and international validation studies |
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