Prognostic factors for post-recurrence survival in patients with completely resected Stage I non-small-cell lung cancer
- Authors
- Song, In Hag; Yeom, Sung Won; Heo, Seohee; Choi, Won Suk; Yang, Hee Chul; Jheon, Sanghoon; Kim, Kwhanmien; Cho, Sukki
- Issue Date
- Feb-2014
- Publisher
- Elsevier BV
- Keywords
- Non-small-cell lung cancer; Stage I; Recurrence; Post-recurrence survival
- Citation
- European Journal of Cardio-thoracic Surgery, v.45, no.2, pp 262 - 267
- Pages
- 6
- Journal Title
- European Journal of Cardio-thoracic Surgery
- Volume
- 45
- Number
- 2
- Start Page
- 262
- End Page
- 267
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/12470
- DOI
- 10.1093/ejcts/ezt333
- ISSN
- 1010-7940
1873-734X
- Abstract
- 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. 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. 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. 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.
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