Identification of subsets of patients with favorable prognosis after recurrence in completely resected non-small cell lung cancer.
Ann Surg Oncol
; 21(8): 2546-54, 2014 Aug.
Article
en En
| MEDLINE
| ID: mdl-24633668
ABSTRACT
BACKGROUND:
This retrospective study aimed to determine prognostic factors associated with postrecurrence survival of completely resected non-small cell cancer patients with postoperative recurrence.METHODS:
Characteristics, treatment modality, and postrecurrence survival of 234 patients (157 males and 77 females, mean age at recurrence 68.7 years, 152 adenocarcinomas and 82 non-adenocarcinomas), who underwent complete resection for non-small cell lung cancer between 2003 and 2009 at our hospital and experienced recurrence, were analyzed for prognostic factors. Cox proportional hazard model was applied for multivariate analysis.RESULTS:
Among 234 patients, the median survival time after the diagnosis of recurrence was 21 months, and the 5-year postrecurrence survival rate was 19.9 %. Eastern Cooperative Oncology Group Performance Status (ECOG PS) (hazard ratio [HR] ECOG PS-0/PS-1/PS-2 = 1/3.313/7.622), time to recurrence after surgery (HR >2 years/1-2 years/<1 year = 1/1.881/2.185), and number of initial recurrent organs (HR 1 organ/2 organs/3 or more organs = 1/1.896/2.818) were independent prognostic factors. Patients who received resection or stereotactic irradiation for limited number of brain metastases or solitary extracranial metastasis, and those who received mediastinal radiation or chemoradiation for recurrence at regional lymph nodes and/or resected stump had better survival (median survival time after recurrence 34, 64, and 25 months, respectively).CONCLUSIONS:
Poor ECOG PS, shorter time from initial surgery to recurrence, and increasing number of initial recurrent regions are associated with poor prognosis after recurrence. When the number of recurrent lesions is limited, intensive local treatment with curative intent should be applied for achieving long-term postrecurrence survival.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Carcinoma de Células Escamosas
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Adenocarcinoma
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Carcinoma de Células Grandes
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Carcinoma de Pulmón de Células no Pequeñas
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Neoplasias Pulmonares
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Recurrencia Local de Neoplasia
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Surg Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2014
Tipo del documento:
Article