Predictors of Recurrence after Curative Resection in Patients with Early-Stage Non-Small Cell Lung Cancer

Tuberculosis and Respiratory Diseases

article

Sang Hee Lee¹  Eun Jung Jo²  Jung Seop Eom²  Jeong Ha Mok²  Mi Hyun Kim²  Kwangha Lee²  Ki Uk Kim²  Hye-Kyung Park²  Chang Hun Lee³  Yeong Dae Kim⁴  Min Ki Lee² 

[1] Department of Internal Medicine, Wonkwang University Sanbon Hospital;Department of Internal Medicine, Pusan National University Hospital;Department of Pathology, Pusan National University Hospital;Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital

关键词: Recurrence;    Carcinoma;    Non-Small-Cell Lung;    Drug Therapy;    Adjuvants;   

DOI  :  10.4046/trd.2015.78.4.341

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

Background There have been various results from studies concerning the predictors of recurrence in early-stage nonsmall cell lung cancer (NSCLC). Therefore, an accurate assessment is needed to guide effective adjuvant therapy. We investigated the predictors of a recurrence in patients with resected, early-stage NSCLC and the risk factors associated with locoregional or distant recurrence. Methods This retrospective study was conducted on patients at the Pusan National University Hospital from January 2006 to December 2011. Patients with pathological stages I or II were included in this study, as based on the seventh edition TNM staging system. Multivariate Cox proportional hazard models were used to identify factors associated with recurrence. Results Two hundred and forty-nine patients were included. Among them, 180 patients were stage I, and 69 were stage II. Overall, by multivariate analysis, the independent factors associated with a 5-year total recurrence were the presence of visceral pleural invasion (VPI) (p=0.018) and maximal standardized uptake values (SUVs) of tumors on positron emission tomography (PET) >4.5 (p=0.037). The VPI was the only independent risk factor associated with both locoregional and distant recurrence, in the analysis of the patterns of tumor recurrence and their risk factors. In the subgroup analysis of stage I patients, three variables (male, VPI and resection margin positive) were significantly associated with a 5-year recurrence. Conclusion The independent factors associated with postoperative recurrence in early-stage NSCLC were as follows: PET SUV >4.5 and the presence of VPI. For patients with those factors adjuvant therapy should be recommended as a more efficacious treatment.

【 授权许可】

CC BY-NC