Telomerase activity as a prognostic indicator in stage I non-small cell lung cancer

Patients with stage I non-small cell lung cancer (NSCLC) are typically trea ted with surgical resection alone. However, about one-third of such patient s develop disease recurrence and die within 5 years after complete resectio n, The ability to predict recurrence could represent an important contribut ion to treatment planning. This study evaluates the presence of telomerase activity in tumor cells as a predictor of disease recurrence and cancer-rel ated death after operation for stage I NSCLC patients. The activity of the telomerase enzyme was investigated by telomeric repeat amplification protoc ol (TRAP) in tumors and matching normal lung tissue samples obtained from 1 07 consecutive operable patients with pathological stage I NSCLC, Telomeras e activity was detected in 66 (62%) of the 107 tumors examined and in none of the corresponding adjacent noncancerous lung tissue samples. Correlation with pathological parameters showed that telomerase activity was associate d with histopathological grade (P = 0.0135) but not with tumor size or hist ological type. Univariate survival curves, estimated using the method of Ka plan and Meier, defined a significant association between telomerase activi ty and both disease-free survival (P = 0.0115) and overall survival (P = 0, 0129). In multivariate analyses, performed by Cox's proportional hazards re gression models, the presence of telomerase activity was the only strong pr edictor of disease-free survival (P = 0.0173) and overall survival (P = 0.0 187), Our data indicate that telomerase activity can be an important progno stic factor that should be considered in future prospective trials of adjuv ant therapy for high-risk stage I NSCLC patients.