Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer

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

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: The purpose of this study was to quantify the risk of late recurrence in patients with stage IA non-small cell lung cancer (NSCLC) who remained recurrence-free for more than 5 years after resection. Methods:Between August 1992 and December 2002, a total of 519 patients with stage IA NSCLC underwent complete resection at our institution. Recurrence-free probability was measured 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. Results: Of a total of 519 patients, 434 remained recurrence-free for 5 years. Among these, 21 (4.8%) developed late recurrence more than 5 years after resection. Recurrence-free interval ranged from 1 to 53 months, and the median recurrence-free interval was 14 months from the benchmark of 5 years after primary tumor resection. The 5-year recurrence-free probability from the benchmark was 93%. Multivariate Cox analysis demonstrated that vascular invasion significantly influenced late recurrence (p = 0.038). The 5-year recurrence-free probability from the benchmark was 84% for patients with vascular invasion and 95% for patients without vascular invasion (p < 0.001). Conclusions: Patients with stage IA NSCLC with vascular invasion harbor a significant risk of late recurrence more than 5 years after complete resection. In patients with stage IA NSCLC with vascular invasion, 5 years without recurrence is not sufficient to conclude that NSCLC is cured. In contrast, patients without vascular invasion may be declared to be cured at 5 years after resection if they are recurrence-free.

Original languageEnglish
Pages (from-to)1246-1250
Number of pages5
JournalJournal of Thoracic Oncology
Volume5
Issue number8
DOIs
Publication statusPublished - 2010 Aug
Externally publishedYes

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Non-Small Cell Lung Carcinoma
Recurrence
Blood Vessels
Benchmarking
Neoplasms
Multivariate Analysis

Keywords

  • Late recurrence
  • Non-small cell lung cancer
  • Stage IA
  • Thoracic surgery

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer. / Maeda, Ryo; Yoshida, Junji; Ishii, Genichiro; Aokage, Keiju; Hishida, Tomoyuki; Nishimura, Mitsuyo; Nishiwaki, Yutaka; Nagai, Kanji.

In: Journal of Thoracic Oncology, Vol. 5, No. 8, 08.2010, p. 1246-1250.

Research output: Contribution to journalArticle

Maeda, Ryo ; Yoshida, Junji ; Ishii, Genichiro ; Aokage, Keiju ; Hishida, Tomoyuki ; Nishimura, Mitsuyo ; Nishiwaki, Yutaka ; Nagai, Kanji. / Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer. In: Journal of Thoracic Oncology. 2010 ; Vol. 5, No. 8. pp. 1246-1250.
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abstract = "Background: The purpose of this study was to quantify the risk of late recurrence in patients with stage IA non-small cell lung cancer (NSCLC) who remained recurrence-free for more than 5 years after resection. Methods:Between August 1992 and December 2002, a total of 519 patients with stage IA NSCLC underwent complete resection at our institution. Recurrence-free probability was measured 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. Results: Of a total of 519 patients, 434 remained recurrence-free for 5 years. Among these, 21 (4.8{\%}) developed late recurrence more than 5 years after resection. Recurrence-free interval ranged from 1 to 53 months, and the median recurrence-free interval was 14 months from the benchmark of 5 years after primary tumor resection. The 5-year recurrence-free probability from the benchmark was 93{\%}. Multivariate Cox analysis demonstrated that vascular invasion significantly influenced late recurrence (p = 0.038). The 5-year recurrence-free probability from the benchmark was 84{\%} for patients with vascular invasion and 95{\%} for patients without vascular invasion (p < 0.001). Conclusions: Patients with stage IA NSCLC with vascular invasion harbor a significant risk of late recurrence more than 5 years after complete resection. In patients with stage IA NSCLC with vascular invasion, 5 years without recurrence is not sufficient to conclude that NSCLC is cured. In contrast, patients without vascular invasion may be declared to be cured at 5 years after resection if they are recurrence-free.",
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