Late recurrence of non-small cell lung cancer more than 5 years after complete resection

Incidence and clinical implications in patient follow-up

Ryo Maeda, Junji Yoshida, Tomoyuki Hishida, Keiju Aokage, Mitsuyo Nishimura, Yutaka Nishiwaki, Kanji Nagai

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: The purpose of this study was to evaluate the risk of late recurrence in patients who had undergone complete resection for non-small cell lung cancer (NSCLC) and remained recurrence-free for ≥ 5 years. Methods: Between 1993 and 2002, 1,358 patients with NSCLC underwent complete primary tumor resection and systematic lymph node dissection. Of these, 819 patients remained recurrence-free for 5 years. Recurrence-free probability was estimated from the benchmark of 5 years after primary tumor resection to the date of first recurrence or last follow-up, using the Kaplan-Meier method. Multivariate Cox regression was used to test the relationship of recurrence-free probability to various clinicopathologic factors. Results: Of the 819 patients who were free of recurrence at 5 years, 87 (11%) developed a subsequent recurrence. The recurrence-free probabilities at 3 years and 5 years from the point of 5 years after primary tumor resection were 92% and 87%, respectively. The 5-year recurrence-free probabilities from the point of 5 years after primary tumor resection were 81% for patients with intratumoral vascular invasion(P < .001), and 89%, 84%, and 65% for patients with N0, N1, and N2 cancers, respectively(P < .001). Multivariate Cox analysis demonstrated that intratumoral vascular invasion and nodal involvement significantly influenced recurrence 5 years after complete resection(P = .030, P = .022, respectively). Conclusions: Patients with NSCLC with selected tumor characteristics have a significant risk of late recurrence. Therefore, 5 years might not be a sufficient amount of time to declare that NSCLC has been cured.

Original languageEnglish
Pages (from-to)145-150
Number of pages6
JournalChest
Volume138
Issue number1
DOIs
Publication statusPublished - 2010 Jul 1
Externally publishedYes

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Non-Small Cell Lung Carcinoma
Recurrence
Incidence
Neoplasms
Blood Vessels
Benchmarking
Lymph Node Excision
Multivariate Analysis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Late recurrence of non-small cell lung cancer more than 5 years after complete resection : Incidence and clinical implications in patient follow-up. / Maeda, Ryo; Yoshida, Junji; Hishida, Tomoyuki; Aokage, Keiju; Nishimura, Mitsuyo; Nishiwaki, Yutaka; Nagai, Kanji.

In: Chest, Vol. 138, No. 1, 01.07.2010, p. 145-150.

Research output: Contribution to journalArticle

Maeda, Ryo ; Yoshida, Junji ; Hishida, Tomoyuki ; Aokage, Keiju ; Nishimura, Mitsuyo ; Nishiwaki, Yutaka ; Nagai, Kanji. / Late recurrence of non-small cell lung cancer more than 5 years after complete resection : Incidence and clinical implications in patient follow-up. In: Chest. 2010 ; Vol. 138, No. 1. pp. 145-150.
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AU - Nishiwaki, Yutaka

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N2 - Background: The purpose of this study was to evaluate the risk of late recurrence in patients who had undergone complete resection for non-small cell lung cancer (NSCLC) and remained recurrence-free for ≥ 5 years. Methods: Between 1993 and 2002, 1,358 patients with NSCLC underwent complete primary tumor resection and systematic lymph node dissection. Of these, 819 patients remained recurrence-free for 5 years. Recurrence-free probability was estimated from the benchmark of 5 years after primary tumor resection to the date of first recurrence or last follow-up, using the Kaplan-Meier method. Multivariate Cox regression was used to test the relationship of recurrence-free probability to various clinicopathologic factors. Results: Of the 819 patients who were free of recurrence at 5 years, 87 (11%) developed a subsequent recurrence. The recurrence-free probabilities at 3 years and 5 years from the point of 5 years after primary tumor resection were 92% and 87%, respectively. The 5-year recurrence-free probabilities from the point of 5 years after primary tumor resection were 81% for patients with intratumoral vascular invasion(P < .001), and 89%, 84%, and 65% for patients with N0, N1, and N2 cancers, respectively(P < .001). Multivariate Cox analysis demonstrated that intratumoral vascular invasion and nodal involvement significantly influenced recurrence 5 years after complete resection(P = .030, P = .022, respectively). Conclusions: Patients with NSCLC with selected tumor characteristics have a significant risk of late recurrence. Therefore, 5 years might not be a sufficient amount of time to declare that NSCLC has been cured.

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