+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Prognostic factors and the significance of treatment after recurrence in completely resected stage I non-small cell lung cancer



Prognostic factors and the significance of treatment after recurrence in completely resected stage I non-small cell lung cancer



Chest 143(6): 1626-1634



The objective of this study was to identify the clinicopathologic factors influencing postrecurrence survival (PRS) in and the effect of postrecurrence therapy (PRT) on patients with completely resected stage I non-small cell lung cancer (NSCLC). We reviewed the data of 919 patients in whom complete resection of stage I NSCLC had been performed. Of the 919 patients, 170 (18.5%) had recurrent disease. Initial PRT was performed in 118 patients (69.1%) (surgery in eight, chemotherapy in 79, radiotherapy in 10, and chemoradiotherapy in 21). On multivariate analyses, PRT (hazard ratio [HR], 0.542; 95% CI, 0.344-0.853; P = .008), female sex (HR, 0.487; 95% CI, 0.297-0.801; P = .005), and differentiation (HR, 1.810; 95% CI, 1.194-2.743; P = .005) demonstrated a statistically significant association with favorable PRS. Bone metastasis (HR, 3.288; 95% CI, 1.783-6.062; P < .001), liver metastasis (HR, 4.518; 95% CI, 1.793-11.379; P = .001), chemotherapy (HR, 0.478; 95% CI, 0.236-0.975; P = .040), epidermal growth factor receptor-tyrosine kinase inhibitors treatment (EGFR-TKIs) (HR, 0.460; 95% CI, 0.245-0.862; P = .015), and nonadenocarcinoma (HR, 2.136; 95% CI, 1.273-3.585; P = .004) were independently and significantly associated with PRS in the 118 patients who underwent any PRT. Subgroup analysis with a combination of these five PRS factors in the patients who underwent any PRT revealed median PRS times of 42.4 months for 20 patients lacking all five risk factors and 18.8 months for 98 patients with at least one of these risk factors (P = .001). PRT, sex, and differentiation were independently associated with PRS. In the patients who underwent any PRT, PRS was related to EGFR-TKIs, chemotherapy, histology, and initial recurrence sites. One challenge for the future will be to create systematic treatment strategies for recurrent NSCLC according to the risk factor status of individual patients.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 055209638

Download citation: RISBibTeXText

PMID: 23348916

DOI: 10.1378/chest.12-1717


Related references

P1.08-066 Prognostic Factors of Post-Recurrence Survival in Patients with Completely Resected Stage Iii-N2 Non-Small Cell Lung Cancer. Journal of Thoracic Oncology 12(1): S771-S772, 2017

Prognostic factors for post-recurrence survival in patients with completely resected Stage III (N2) non-small-cell lung cancer. European Journal of Cardio-Thoracic Surgery 54(3): 554-559, 2018

Prognostic factors for post-recurrence survival in patients with completely resected Stage I non-small-cell lung cancer. European Journal of Cardio-Thoracic Surgery 45(2): 262-267, 2014

The prognostic impact of preoperative PET-CT on postoperative recurrence for completely resected stage I non-small cell lung cancer. Zhonghua Wai Ke Za Zhi 53(7): 502-507, 2015

Prognostic factors of tumor recurrence in completely resected non-small cell lung cancer. Cancer Management and Research 5: 77-84, 2013

Prognostic factors in patients with postoperative brain recurrence from completely resected non-small cell lung cancer. Thoracic Cancer 6(1): 38-42, 2015

Biological prognostic factors for early stage completely resected non-small cell lung cancer. Journal of Surgical Oncology 74(1): 53-60, 2000

Prognostic factors of postrecurrence survival in completely resected stage I non-small cell lung cancer with distant metastasis. Thorax 65(3): 241-245, 2010

Prognostic factors in 3315 completely resected cases of clinical stage I non-small cell lung cancer in Japan. Journal of Thoracic Oncology 2(5): 408-413, 2007

Prognostic significance of postoperative serum carcinoembryonic antigen levels in patients with completely resected pathological-stage I non-small cell lung cancer. Journal of Cardiothoracic Surgery 8: 106, 2013

Post-recurrence survival in completely resected stage I non-small cell lung cancer with local recurrence. Thorax 64(3): 192-196, 2009

Prognostic Factors for Post Recurrence Survival in Resected Pathological Stage I Non-small Cell Lung Cancer. Yonago Acta Medica 60(4): 213-219, 2017

Prognostic factors obtained by a pathologic examination in completely resected non-small-cell lung cancer. An analysis in each pathologic stage. Journal of Thoracic and Cardiovascular Surgery 110(3): 601-605, 1995

Completely resected non-small cell lung cancer: reconsidering prognostic value and significance of N2 metastases. Annals of Thoracic Surgery 84(6): 1818-1824, 2007

Prognostic significance of apoptotic index in completely resected non-small-cell lung cancer. Journal of Clinical Oncology 17(9): 2728-2736, 1999