Yuki Matsumura1, Motoki Yano2, Junji Yoshida3, Terumoto Koike4, Kotaro Kameyama5, Akira Shimamoto6, Wataru Nishio7, Kentaro Yoshimoto8, Tomoki Utsumi9, Takayuki Shiina10, Atsushi Watanabe11, Yasushi Yamato12, Takehiro Watanabe13, Yusuke Takahashi14, Makoto Sonobe15, Hiroaki Kuroda16, Makoto Oda17, Masayoshi Inoue18, Masayuki Tanahashi19, Hirofumi Adachi20, Masao Saito21, Masataro Hayashi22, Hajime Otsuka23, Teruaki Mizobuchi24, Yasumitsu Moriya25, Mamoru Takahashi26, Shigeto Nishikawa27, Hiroyuki Suzuki28. 1. Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan Division of Chest Surgery, Fukushima Medical University, Fukushima, Japan yukimatsumura1980@gmail.com. 2. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. 3. Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan. 4. Department of Thoracic and Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. 5. Department of Thoracic Surgery, Kurashiki Central Hospital, Kurashiki, Japan. 6. Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu, Japan. 7. Department of General Thoracic Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan. 8. Department of Thoracic Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan. 9. Department of Surgery, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan. 10. Department of Thoracic Surgery, Shinshu University School of Medicine, Matsumoto, Japan. 11. Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan. 12. Department of Thoracic Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan. 13. Department of Thoracic Surgery, National Hospital Organization Nishi-Niigata Chuo National Hospital, Niigata, Japan. 14. Department of General Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Tokyo, Japan. 15. Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan. 16. Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan. 17. Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan. 18. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 19. Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan. 20. Department of Thoracic Surgery, Hokkaido Cancer Center, Sapporo, Japan. 21. Department of Thoracic Surgery, Tenri Hospital, Nara, Japan. 22. Department of Surgery and Clinical Science, Division of Chest Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. 23. Department of Chest Surgery, Toho University Omori Medical Center, Tokyo, Japan. 24. Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. 25. Division of Thoracic Surgery, Chiba Cancer Center, Chiba, Japan. 26. Department of Chest Surgery, Fukui Red Cross Hospital, Fukui, Japan. 27. Division of Thoracic Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan. 28. Division of Chest Surgery, Fukushima Medical University, Fukushima, Japan.
Abstract
OBJECTIVES: In 2015, we reported the outcomes of patients undergoing intentional limited resection (ILR) for non-small-cell lung cancer (NSCLC) from a retrospective, multi-institutional large database in Japan. Here, we analyse the clinicopathological characteristics of the patients extracted from this database with late recurrence and compare them with those with early recurrence. METHODS: Of 1538 patients in the database with cT1aN0M0 NSCLC, 92 (6%) had recurrence. In this study, early recurrence was defined as recurrence within 5 years and late recurrence as recurrence beyond 5 years after surgery. We compared the clinicopathological characteristics and post-recurrence survival (PRS) between patients with early and late recurrence. RESULTS: Of the 92 patients with recurrence, 21 (23%) had late recurrence. Compared with the early recurrence group, there were significantly more adenocarcinomas and local recurrences in the late recurrence group (P = 0.04 for both). The 3- and 5-year PRS rates were 53 and 24%, respectively, and the median PRS period was 38 months. There were no significant differences in the PRS curves between patients with early and late recurrence (P = 0.12). Only 3 patients (0.2%) had recurrence more than 10 years after ILR. Of the 21 late-recurrence patients, 17 (81%) had tumours with a consolidation/tumour ratio (CTR) >0.25. CONCLUSIONS: Late recurrence occurred in 21 (23%) of 92 patients with recurrence after ILR for cT1aN0M0 NSCLC. Late recurrence was more likely to involve adenocarcinoma and local recurrence. It is thus considered reasonable to follow patients with a CTR >0.25 for 10 years after ILR.
OBJECTIVES: In 2015, we reported the outcomes of patients undergoing intentional limited resection (ILR) for non-small-cell lung cancer (NSCLC) from a retrospective, multi-institutional large database in Japan. Here, we analyse the clinicopathological characteristics of the patients extracted from this database with late recurrence and compare them with those with early recurrence. METHODS: Of 1538 patients in the database with cT1aN0M0 NSCLC, 92 (6%) had recurrence. In this study, early recurrence was defined as recurrence within 5 years and late recurrence as recurrence beyond 5 years after surgery. We compared the clinicopathological characteristics and post-recurrence survival (PRS) between patients with early and late recurrence. RESULTS: Of the 92 patients with recurrence, 21 (23%) had late recurrence. Compared with the early recurrence group, there were significantly more adenocarcinomas and local recurrences in the late recurrence group (P = 0.04 for both). The 3- and 5-year PRS rates were 53 and 24%, respectively, and the median PRS period was 38 months. There were no significant differences in the PRS curves between patients with early and late recurrence (P = 0.12). Only 3 patients (0.2%) had recurrence more than 10 years after ILR. Of the 21 late-recurrence patients, 17 (81%) had tumours with a consolidation/tumour ratio (CTR) >0.25. CONCLUSIONS: Late recurrence occurred in 21 (23%) of 92 patients with recurrence after ILR for cT1aN0M0 NSCLC. Late recurrence was more likely to involve adenocarcinoma and local recurrence. It is thus considered reasonable to follow patients with a CTR >0.25 for 10 years after ILR.