Predictors of post-recurrence survival in patients with non-small-cell lung cancer initially completely resected

Yusuke Takahashi, Hirotoshi Horio, Tai Hato, Masahiko Harada, Noriyuki Matsutani, Masafumi Kawamura

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVES Despite recent progress in diagnostic technology and therapeutic approaches to non-small-cell lung cancer (NSCLC), 30-75% of patients develop tumour recurrence after resection. However, the details of post-recurrence survival (PRS) are not well understood. We aimed to investigate the predictors of PRS in patients with NSCLC initially completely resected. METHODS A series of 568 NSCLC patients who had undergone complete resection between 2000 and 2009 were evaluated retrospectively. Patients who had developed recurrent NSCLC after complete resection were subjected to the current analysis. We examined PRS using the Kaplan-Meier method and multivariate Cox regression analyses. RESULTS Of the 568 patients, 138 (24.3%) were identified as having disease recurrence. The 2-year and 5-year PRS rates were 44.6 and 25.9%, respectively, while the median PRS time was 22.5 months. Non-adenocarcinoma histology [hazard ratio (HR) = 2.825, 95% confidence interval (CI): 1.825-4.367, P < 0.001], serum carcinoembryonic antigen (CEA) at recurrence >5.0 mg/dl (HR = 2.205, 95% CI: 1.453-3.344, P < 0.001) and no systemic chemotherapy (HR = 2.137, 95% CI: 1.304-3.247, P = 0.002) were independent prognostic factors for PRS. CONCLUSIONS The current results showed that non-adenocarcinoma histology, elevated serum CEA at recurrence and no systemic chemotherapy were independent unfavourable post-recurrence prognostic factors. The current data can be informative for patient follow-up after complete resection and further clinical investigation may give us more information about PRS and accurate treatment strategy for recurrent NSCLC after initial complete resection.

Original languageEnglish
Pages (from-to)14-20
Number of pages7
JournalInteractive Cardiovascular and Thoracic Surgery
Volume21
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1
Externally publishedYes

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Non-Small Cell Lung Carcinoma
Recurrence
Survival
Confidence Intervals
Histology
Drug Therapy
Survival Rate
Regression Analysis
Technology

Keywords

  • Post-recurrence survival
  • Prognostic factor
  • Systemic chemotherapy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Predictors of post-recurrence survival in patients with non-small-cell lung cancer initially completely resected. / Takahashi, Yusuke; Horio, Hirotoshi; Hato, Tai; Harada, Masahiko; Matsutani, Noriyuki; Kawamura, Masafumi.

In: Interactive Cardiovascular and Thoracic Surgery, Vol. 21, No. 1, 01.01.2015, p. 14-20.

Research output: Contribution to journalArticle

Takahashi, Yusuke ; Horio, Hirotoshi ; Hato, Tai ; Harada, Masahiko ; Matsutani, Noriyuki ; Kawamura, Masafumi. / Predictors of post-recurrence survival in patients with non-small-cell lung cancer initially completely resected. In: Interactive Cardiovascular and Thoracic Surgery. 2015 ; Vol. 21, No. 1. pp. 14-20.
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abstract = "OBJECTIVES Despite recent progress in diagnostic technology and therapeutic approaches to non-small-cell lung cancer (NSCLC), 30-75{\%} of patients develop tumour recurrence after resection. However, the details of post-recurrence survival (PRS) are not well understood. We aimed to investigate the predictors of PRS in patients with NSCLC initially completely resected. METHODS A series of 568 NSCLC patients who had undergone complete resection between 2000 and 2009 were evaluated retrospectively. Patients who had developed recurrent NSCLC after complete resection were subjected to the current analysis. We examined PRS using the Kaplan-Meier method and multivariate Cox regression analyses. RESULTS Of the 568 patients, 138 (24.3{\%}) were identified as having disease recurrence. The 2-year and 5-year PRS rates were 44.6 and 25.9{\%}, respectively, while the median PRS time was 22.5 months. Non-adenocarcinoma histology [hazard ratio (HR) = 2.825, 95{\%} confidence interval (CI): 1.825-4.367, P < 0.001], serum carcinoembryonic antigen (CEA) at recurrence >5.0 mg/dl (HR = 2.205, 95{\%} CI: 1.453-3.344, P < 0.001) and no systemic chemotherapy (HR = 2.137, 95{\%} CI: 1.304-3.247, P = 0.002) were independent prognostic factors for PRS. CONCLUSIONS The current results showed that non-adenocarcinoma histology, elevated serum CEA at recurrence and no systemic chemotherapy were independent unfavourable post-recurrence prognostic factors. The current data can be informative for patient follow-up after complete resection and further clinical investigation may give us more information about PRS and accurate treatment strategy for recurrent NSCLC after initial complete resection.",
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T1 - Predictors of post-recurrence survival in patients with non-small-cell lung cancer initially completely resected

AU - Takahashi, Yusuke

AU - Horio, Hirotoshi

AU - Hato, Tai

AU - Harada, Masahiko

AU - Matsutani, Noriyuki

AU - Kawamura, Masafumi

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N2 - OBJECTIVES Despite recent progress in diagnostic technology and therapeutic approaches to non-small-cell lung cancer (NSCLC), 30-75% of patients develop tumour recurrence after resection. However, the details of post-recurrence survival (PRS) are not well understood. We aimed to investigate the predictors of PRS in patients with NSCLC initially completely resected. METHODS A series of 568 NSCLC patients who had undergone complete resection between 2000 and 2009 were evaluated retrospectively. Patients who had developed recurrent NSCLC after complete resection were subjected to the current analysis. We examined PRS using the Kaplan-Meier method and multivariate Cox regression analyses. RESULTS Of the 568 patients, 138 (24.3%) were identified as having disease recurrence. The 2-year and 5-year PRS rates were 44.6 and 25.9%, respectively, while the median PRS time was 22.5 months. Non-adenocarcinoma histology [hazard ratio (HR) = 2.825, 95% confidence interval (CI): 1.825-4.367, P < 0.001], serum carcinoembryonic antigen (CEA) at recurrence >5.0 mg/dl (HR = 2.205, 95% CI: 1.453-3.344, P < 0.001) and no systemic chemotherapy (HR = 2.137, 95% CI: 1.304-3.247, P = 0.002) were independent prognostic factors for PRS. CONCLUSIONS The current results showed that non-adenocarcinoma histology, elevated serum CEA at recurrence and no systemic chemotherapy were independent unfavourable post-recurrence prognostic factors. The current data can be informative for patient follow-up after complete resection and further clinical investigation may give us more information about PRS and accurate treatment strategy for recurrent NSCLC after initial complete resection.

AB - OBJECTIVES Despite recent progress in diagnostic technology and therapeutic approaches to non-small-cell lung cancer (NSCLC), 30-75% of patients develop tumour recurrence after resection. However, the details of post-recurrence survival (PRS) are not well understood. We aimed to investigate the predictors of PRS in patients with NSCLC initially completely resected. METHODS A series of 568 NSCLC patients who had undergone complete resection between 2000 and 2009 were evaluated retrospectively. Patients who had developed recurrent NSCLC after complete resection were subjected to the current analysis. We examined PRS using the Kaplan-Meier method and multivariate Cox regression analyses. RESULTS Of the 568 patients, 138 (24.3%) were identified as having disease recurrence. The 2-year and 5-year PRS rates were 44.6 and 25.9%, respectively, while the median PRS time was 22.5 months. Non-adenocarcinoma histology [hazard ratio (HR) = 2.825, 95% confidence interval (CI): 1.825-4.367, P < 0.001], serum carcinoembryonic antigen (CEA) at recurrence >5.0 mg/dl (HR = 2.205, 95% CI: 1.453-3.344, P < 0.001) and no systemic chemotherapy (HR = 2.137, 95% CI: 1.304-3.247, P = 0.002) were independent prognostic factors for PRS. CONCLUSIONS The current results showed that non-adenocarcinoma histology, elevated serum CEA at recurrence and no systemic chemotherapy were independent unfavourable post-recurrence prognostic factors. The current data can be informative for patient follow-up after complete resection and further clinical investigation may give us more information about PRS and accurate treatment strategy for recurrent NSCLC after initial complete resection.

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KW - Prognostic factor

KW - Systemic chemotherapy

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