OBJECTIVES: Recently, the prognosis of patients with non-small-cell lung cancer (NSCLC) has improved, thanks to the standardization of adjuvant chemotherapy and the introduction of molecular-targeted drugs, notably epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors and other new anti-cancer agents. However, the survival characteristics and prognosis of patients with recurrent NSCLC after curative resection are not well understood. METHODS: Of the 430 consecutive patients with NSCLC who underwent complete surgical resection at our institution between January 2004 and July 2011, we included 76 patients with recurrence whose post-recurrence treatment and outcome could be confirmed. We then retrospectively evaluated the effect of prognostic factors on post-recurrence survival. RESULTS: There were 50 men and 26 women, and the median age at recurrence was 74.5 years. The median time from surgical resection to recurrence was 12.7 months. Thirty-eight of the 76 (50%) patients underwent multimodality treatment with surgery and preoperative and/or postoperative chemotherapy as their initial treatment. For recurrence, systemic chemotherapy was administered to 64 (84%) patients, and the disease control rate for first-line chemotherapy was 55%. The 1- and 2-year post-recurrence survival rates were 68.3 and 45.8%, respectively, and the median post-recurrence survival time was 17.7 months. Six independent prognostic factors were identified: wild-type EGFR, no adjuvant chemotherapy for the primary lung cancer, age ≥ 80 years at recurrence, a poor Eastern Cooperative Oncology Group performance status at recurrence, symptomatic at recurrence and no systemic chemotherapy for recurrence, which significantly decreased the post-recurrence survival. CONCLUSIONS: The prognosis of patients with NSCLC recurrence after surgery is currently improving. Our results suggested two new prognostic factors, adjuvant chemotherapy and EGFR mutations, neither of which have been previously reported. Treatment strategies for postoperative recurrence should be established based on a more detailed subdivision of factors, such as histology and molecular markers, in the future.
OBJECTIVES: Recently, the prognosis of patients with non-small-cell lung cancer (NSCLC) has improved, thanks to the standardization of adjuvant chemotherapy and the introduction of molecular-targeted drugs, notably epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors and other new anti-cancer agents. However, the survival characteristics and prognosis of patients with recurrent NSCLC after curative resection are not well understood. METHODS: Of the 430 consecutive patients with NSCLC who underwent complete surgical resection at our institution between January 2004 and July 2011, we included 76 patients with recurrence whose post-recurrence treatment and outcome could be confirmed. We then retrospectively evaluated the effect of prognostic factors on post-recurrence survival. RESULTS: There were 50 men and 26 women, and the median age at recurrence was 74.5 years. The median time from surgical resection to recurrence was 12.7 months. Thirty-eight of the 76 (50%) patients underwent multimodality treatment with surgery and preoperative and/or postoperative chemotherapy as their initial treatment. For recurrence, systemic chemotherapy was administered to 64 (84%) patients, and the disease control rate for first-line chemotherapy was 55%. The 1- and 2-year post-recurrence survival rates were 68.3 and 45.8%, respectively, and the median post-recurrence survival time was 17.7 months. Six independent prognostic factors were identified: wild-type EGFR, no adjuvant chemotherapy for the primary lung cancer, age ≥ 80 years at recurrence, a poor Eastern Cooperative Oncology Group performance status at recurrence, symptomatic at recurrence and no systemic chemotherapy for recurrence, which significantly decreased the post-recurrence survival. CONCLUSIONS: The prognosis of patients with NSCLC recurrence after surgery is currently improving. Our results suggested two new prognostic factors, adjuvant chemotherapy and EGFR mutations, neither of which have been previously reported. Treatment strategies for postoperative recurrence should be established based on a more detailed subdivision of factors, such as histology and molecular markers, in the future.
Authors: Jean-Yves Douillard; Rafael Rosell; Mario De Lena; Francesco Carpagnano; Rodryg Ramlau; Jose Luis Gonzáles-Larriba; Tomasz Grodzki; Jose Rodrigues Pereira; Alain Le Groumellec; Vito Lorusso; Claude Clary; Antonio J Torres; Jabrail Dahabreh; Pierre-Jean Souquet; Julio Astudillo; Pierre Fournel; Angel Artal-Cortes; Jacek Jassem; Leona Koubkova; Patricia His; Marcello Riggi; Patrick Hurteloup Journal: Lancet Oncol Date: 2006-09 Impact factor: 41.316
Authors: David S Ettinger; Gerold Bepler; Raphael Bueno; Andrew Chang; Joe Y Chang; Lucian R Chirieac; Thomas A D'Amico; Todd L Demmy; Steven J Feigenberg; Frederic W Grannis; Thierry Jahan; Mohammad Jahanzeb; Anne Kessinger; Ritsuko Komaki; Mark G Kris; Corey J Langer; Quynh-Thu Le; Renato Martins; Gregory A Otterson; Francisco Robert; David J Sugarbaker; Douglas E Wood Journal: J Natl Compr Canc Netw Date: 2006-07 Impact factor: 11.908
Authors: Hiroshi Sugimura; Francis C Nichols; Ping Yang; Mark S Allen; Stephen D Cassivi; Claude Deschamps; Brent A Williams; Peter C Pairolero Journal: Ann Thorac Surg Date: 2007-02 Impact factor: 4.330
Authors: Jan P van Meerbeeck; Gijs W P M Kramer; Paul E Y Van Schil; Catherine Legrand; Egbert F Smit; Franz Schramel; Vivianne C Tjan-Heijnen; Bonne Biesma; Channa Debruyne; Nico van Zandwijk; Ted A W Splinter; Giuseppe Giaccone Journal: J Natl Cancer Inst Date: 2007-03-21 Impact factor: 13.506
Authors: Timothy Winton; Robert Livingston; David Johnson; James Rigas; Michael Johnston; Charles Butts; Yvon Cormier; Glenwood Goss; Richard Inculet; Eric Vallieres; Willard Fry; Drew Bethune; Joseph Ayoub; Keyue Ding; Lesley Seymour; Barbara Graham; Ming-Sound Tsao; David Gandara; Kenneth Kesler; Todd Demmy; Frances Shepherd Journal: N Engl J Med Date: 2005-06-23 Impact factor: 91.245
Authors: Valerie W Rusch; Dorothy J Giroux; Michael J Kraut; John Crowley; Mark Hazuka; Timothy Winton; David H Johnson; Lawrence Shulman; Frances Shepherd; Claude Deschamps; Robert B Livingston; David Gandara Journal: J Clin Oncol Date: 2007-01-20 Impact factor: 44.544
Authors: Brent A Williams; Hiroshi Sugimura; Chiaki Endo; Francis C Nichols; Stephen D Cassivi; Mark S Allen; Peter C Pairolero; Claude Deschamps; Ping Yang Journal: Ann Thorac Surg Date: 2006-03 Impact factor: 4.330