Terumoto Koike1, Tatsuya Goto1, Akihiko Kitahara1, Seijiro Sato1, Masayuki Saitoh2, Takehisa Hashimoto1,3, Osamu Namura1, Masashi Takahashi1,4, Shin-Ichi Toyabe5, Masanori Tsuchida6. 1. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan. 2. Department of Chest Surgery, Niigata Prefectural Central Hospital, 205 Shinnan-cho, Joetsu, Niigata, Japan. 3. Department of Respiratory Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132 Urasa, Minami-uonuma, Niigata, Japan. 4. Division of Disaster Medicine and Medical Professionals Development, Department of Community Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, Japan. 5. Niigata University Crisis Management Office, Niigata University, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Niigata, Japan. 6. Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan. masatsu@med.niigata-u.ac.jp.
Abstract
PURPOSE: To establish the most effective methods of postoperative surveillance to detect early recurrence of lung adenocarcinoma. METHODS: The subjects of this retrospective study were 485 patients with p-stage I-III lung adenocarcinoma, who underwent postoperative surveillance. We examined the sites and detection modes of recurrence and calculated the recurrence-free probabilities. Patients with stage I disease were divided into low- and high-risk recurrence groups using a risk score calculated by assigning points proportional to risk factor regression coefficients. RESULTS: Of the 112 patients with recurrence, 86 had intrathoracic recurrence. Routine computed tomography (CT) revealed recurrence in 60 patients. The recurrence-free probability curves showed that 95% of recurrences were identified within the first 4 years after resection in patients with stage II/III disease. In patients with stage I disease, the predictors of recurrence included male sex, positive pleural lavage cytology, moderate-to-poor differentiation, and visceral pleural invasion. Postoperative recurrences were detected throughout the follow-up period in the high-risk group. CONCLUSIONS: Routine chest CT plays an important role in the postoperative surveillance of lung adenocarcinoma. We recommend intensive follow-up during the early post-resection period for patients with advanced stage disease and long-term follow-up for high-risk patients with stage I disease.
PURPOSE: To establish the most effective methods of postoperative surveillance to detect early recurrence of lung adenocarcinoma. METHODS: The subjects of this retrospective study were 485 patients with p-stage I-III lung adenocarcinoma, who underwent postoperative surveillance. We examined the sites and detection modes of recurrence and calculated the recurrence-free probabilities. Patients with stage I disease were divided into low- and high-risk recurrence groups using a risk score calculated by assigning points proportional to risk factor regression coefficients. RESULTS: Of the 112 patients with recurrence, 86 had intrathoracic recurrence. Routine computed tomography (CT) revealed recurrence in 60 patients. The recurrence-free probability curves showed that 95% of recurrences were identified within the first 4 years after resection in patients with stage II/III disease. In patients with stage I disease, the predictors of recurrence included male sex, positive pleural lavage cytology, moderate-to-poor differentiation, and visceral pleural invasion. Postoperative recurrences were detected throughout the follow-up period in the high-risk group. CONCLUSIONS: Routine chest CT plays an important role in the postoperative surveillance of lung adenocarcinoma. We recommend intensive follow-up during the early post-resection period for patients with advanced stage disease and long-term follow-up for high-risk patients with stage I disease.
Authors: Michael T Jaklitsch; Francine L Jacobson; John H M Austin; John K Field; James R Jett; Shaf Keshavjee; Heber MacMahon; James L Mulshine; Reginald F Munden; Ravi Salgia; Gary M Strauss; Scott J Swanson; William D Travis; David J Sugarbaker Journal: J Thorac Cardiovasc Surg Date: 2012-07 Impact factor: 5.209
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Authors: Benedikt H Heidinger; Ursula Schwarz-Nemec; Kevin R Anderson; Constance de Margerie-Mellon; Antonio C Monteiro Filho; Yigu Chen; Marius E Mayerhoefer; Paul A VanderLaan; Alexander A Bankier Journal: Radiol Cardiothorac Imaging Date: 2019-08-29