OBJECTIVES: The clinical course from recurrence to cancer-related death after curative resection has not been clearly elucidated in non-small-cell lung cancer (NSCLC). This study examined the clinical outcomes after postoperative recurrence in patients with completely resected Stage I NSCLC. METHODS: This study included patients who had recurrence after complete resection for pathological Stage I NSCLC between 2003 and 2009. Clinical data evaluated in this study included the diagnostic process of recurrence, recurrence pattern, treatment process and prognosis. A number of clinicopathological factors were analysed for post-recurrence survival by univariate and multivariate analyses. RESULTS: Seventy-two patients experienced recurrence during a median follow-up period of 37.5 months. Thirteen patients (18%) presented symptoms at the initial recurrence. Tumour markers, computed tomography (CT) and positron emission tomography/CT were chosen as the initial diagnostic tools and detected recurrences in 1 (1%), 51 (71%) and 7 (10%) patients, respectively. The mean recurrence-free interval (RFI) was 15.4 months (≤12 months in 34, >12 months in 38 patients). The patterns of recurrence were presented as loco-regional recurrence in 36 (50%) and distant metastasis in 36 patients (50%). Types of the initial treatment included operations in 28 (39%), chemotherapy and/or radiotherapy in 38 (53%) and radiofrequency ablation in 2 patients (3%). Four patients (6%) rejected treatment. Forty-three patients (62%) presented a good response to the initial treatment. Thirty-seven patients (51%) died, and the cause of death in all of these patients was cancer-related. The median survival duration after recurrence was 43.6 (1-136) months. Univariate analysis identified no recurrence of symptoms, a good response to treatment and a longer RFI as good prognostic factors, while a good response to treatment and a longer RFI were independent prognostic factors in multivariate analysis. CONCLUSIONS: Most postoperative recurrences were detected in an asymptomatic condition during the routine follow-up period, and a good response to initial treatment and a longer RFI were significant predictors of better post-recurrence survival in patients with completely resected Stage I NSCLC.
OBJECTIVES: The clinical course from recurrence to cancer-related death after curative resection has not been clearly elucidated in non-small-cell lung cancer (NSCLC). This study examined the clinical outcomes after postoperative recurrence in patients with completely resected Stage I NSCLC. METHODS: This study included patients who had recurrence after complete resection for pathological Stage I NSCLC between 2003 and 2009. Clinical data evaluated in this study included the diagnostic process of recurrence, recurrence pattern, treatment process and prognosis. A number of clinicopathological factors were analysed for post-recurrence survival by univariate and multivariate analyses. RESULTS: Seventy-two patients experienced recurrence during a median follow-up period of 37.5 months. Thirteen patients (18%) presented symptoms at the initial recurrence. Tumour markers, computed tomography (CT) and positron emission tomography/CT were chosen as the initial diagnostic tools and detected recurrences in 1 (1%), 51 (71%) and 7 (10%) patients, respectively. The mean recurrence-free interval (RFI) was 15.4 months (≤12 months in 34, >12 months in 38 patients). The patterns of recurrence were presented as loco-regional recurrence in 36 (50%) and distant metastasis in 36 patients (50%). Types of the initial treatment included operations in 28 (39%), chemotherapy and/or radiotherapy in 38 (53%) and radiofrequency ablation in 2 patients (3%). Four patients (6%) rejected treatment. Forty-three patients (62%) presented a good response to the initial treatment. Thirty-seven patients (51%) died, and the cause of death in all of these patients was cancer-related. The median survival duration after recurrence was 43.6 (1-136) months. Univariate analysis identified no recurrence of symptoms, a good response to treatment and a longer RFI as good prognostic factors, while a good response to treatment and a longer RFI were independent prognostic factors in multivariate analysis. CONCLUSIONS: Most postoperative recurrences were detected in an asymptomatic condition during the routine follow-up period, and a good response to initial treatment and a longer RFI were significant predictors of better post-recurrence survival in patients with completely resected Stage I NSCLC.
Entities:
Keywords:
Non-small-cell lung cancer; Post-recurrence survival; Recurrence; Stage I
Authors: Hideki Ujiie; Kyuichi Kadota; Jamie E Chaft; Daniel Buitrago; Camelia S Sima; Ming-Ching Lee; James Huang; William D Travis; Nabil P Rizk; Charles M Rudin; David R Jones; Prasad S Adusumilli Journal: J Clin Oncol Date: 2015-08-10 Impact factor: 44.544
Authors: Clara Bayarri-Lara; Francisco G Ortega; Antonio Cueto Ladrón de Guevara; Jose L Puche; Javier Ruiz Zafra; Diego de Miguel-Pérez; Abel Sánchez-Palencia Ramos; Carlos Fernando Giraldo-Ospina; Juan A Navajas Gómez; Miguel Delgado-Rodriguez; Jose A Lorente; María Jose Serrano Journal: PLoS One Date: 2016-02-25 Impact factor: 3.240