Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Predictors of Recurrence after Curative Resection in Patients with Early-Stage Non-Small Cell Lung Cancer

  • Lee, Sang Hee (Department of Internal Medicine, Wonkwang University Sanbon Hospital) ;
  • Jo, Eun Jung (Department of Internal Medicine, Pusan National University Hospital) ;
  • Eom, Jung Seop (Department of Internal Medicine, Pusan National University Hospital) ;
  • Mok, Jeong Ha (Department of Internal Medicine, Pusan National University Hospital) ;
  • Kim, Mi Hyun (Department of Internal Medicine, Pusan National University Hospital) ;
  • Lee, Kwangha (Department of Internal Medicine, Pusan National University Hospital) ;
  • Kim, Ki Uk (Department of Internal Medicine, Pusan National University Hospital) ;
  • Park, Hye-Kyung (Department of Internal Medicine, Pusan National University Hospital) ;
  • Lee, Chang Hun (Department of Pathology, Pusan National University Hospital) ;
  • Kim, Yeong Dae (Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital) ;
  • Lee, Min Ki (Department of Internal Medicine, Pusan National University Hospital)
  • Received : 2015.04.01
  • Accepted : 2015.06.15
  • Published : 2015.10.30
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Abstract

Background: There have been various results from studies concerning the predictors of recurrence in early-stage nonsmall cell lung cancer (NSCLC). Therefore, an accurate assessment is needed to guide effective adjuvant therapy. We investigated the predictors of a recurrence in patients with resected, early-stage NSCLC and the risk factors associated with locoregional or distant recurrence. Methods: This retrospective study was conducted on patients at the Pusan National University Hospital from January 2006 to December 2011. Patients with pathological stages I or II were included in this study, as based on the seventh edition TNM staging system. Multivariate Cox proportional hazard models were used to identify factors associated with recurrence. Results: Two hundred and forty-nine patients were included. Among them, 180 patients were stage I, and 69 were stage II. Overall, by multivariate analysis, the independent factors associated with a 5-year total recurrence were the presence of visceral pleural invasion (VPI) (p=0.018) and maximal standardized uptake values (SUVs) of tumors on positron emission tomography (PET) >4.5 (p=0.037). The VPI was the only independent risk factor associated with both locoregional and distant recurrence, in the analysis of the patterns of tumor recurrence and their risk factors. In the subgroup analysis of stage I patients, three variables (male, VPI and resection margin positive) were significantly associated with a 5-year recurrence. Conclusion: The independent factors associated with postoperative recurrence in early-stage NSCLC were as follows: PET SUV >4.5 and the presence of VPI. For patients with those factors adjuvant therapy should be recommended as a more efficacious treatment.

Keywords

References

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