Browse > Article

Risk Factors for Recurrence in Completely Resected pT1/2N1 Non-small Cell Lung Cancer  

Park Inkyu (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine)
Chung Kyung Young (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine)
Kim Kil Dong (Department of Thoracic and Cardiovascular Surgery, Eulji University School of Medicine)
Joo Hyun Chul (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine)
Kim Dae Joon (Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine)
Publication Information
Journal of Chest Surgery / v.38, no.6, 2005 , pp. 421-427 More about this Journal
Abstract
Complete surgical resection is the most effective treatment for pT1/2N1 non-small cell lung cancer, however 5 year survival rate of these patients is about $40\%$ and the major cause of death is recurrent disease. We intended to clarify the risk factors of recurrence in completely resected pT1/2N1 non-small cell lung cancer. Material and Method: From Jan. f990 to Jul. 2003, total of 117 patients were operated for pT1/2N1 non-small cell lung cancer. The risk of recurrence according to patients characteristics, histopathologic findings, type of resection, pattern of lymph node metastasis, postoperative adjuvant treatment were evaluated retrospectively. Result: Mean age of patients was 59.3 years. There were 14 patients with T1N1 and 103 patients with T2N1 disease. Median follow-up time was 27.5 months and overall 5 year suwival rate was $41.3\%$. 5 year freedom-from recurrence rate was $54.1\%$. Recurrence was observed in $44 (37.6\%)$ patients and distant recurrence developed in 40 patients. 5 year survival rate of patients with recurence was $3.3\%$, which was significantly lower than patients without recurrence $(61.3\%,\;p=0.000).$ In multi-variate analysis of risk factors for freedom-from recurrence rate, multi-station N1 $(hazard\;ratio=1.997,\;p=0.047)$ was a poor prognostic factor. Conclusion: Multi-station N1 is the risk factor for recurrence in completely resected pT1/2N1 non-small cell lung cancer.
Keywords
Carcinoma; non-small cell lung; Neoplasm staging; Neoplasm recurrence;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Osaki T, Nagashima A, Yoshimatsu T, Tashima Y, Yasumoto K. Survival and characteristics of lymph node involvement in patients with N1 non-small cell lung cancer. Lung Cancer 2004;43:151-7   DOI   ScienceOn
2 Scott WJ, Howington J, Movsaa B. Treatment of stage II non-small cell lung cancer. Chest 2003;123:188S-201S   DOI   ScienceOn
3 Naruke T, Suemasu K, Ishogawa S. Lymph node mapping and curability at various level of metastasis in resected lung cancer. J Thorac Cardiovasc Surg 1978;76:832-9
4 Naruke T, Tsuchiya R, Kondo H, Asamura H. Prognosis and survival after resection for bronchogenic carcinoma. Based on the 1997 TNM-staging Classificaiton: The Japanese experience. Ann Thorac Surg 2001;71:1759-64   DOI   ScienceOn
5 Rea F, Marulli G, Callegaro D, et al. Prognostic significance of main bronchial lymph nodes involvement in non-small cell lung carcinoma: N1 or N2? Lung Cancer 2004;45:215-20   DOI   ScienceOn
6 Mountain CF. Revision in the international system for staging lung cancer. Chest 1997;111:1710-7   DOI   PUBMED   ScienceOn
7 Strauss M, Herndon J, Maddaus MA, et al. Randomized clinical trial of adjuvant chemotherapy with paclitaxel and carboplatin following resection in Stage IB non-small cell lung cancer: Report of Cancer and Leukemia Group B (CALGB) Protocol 9633. J Clin Oncol (Meeting Abstracts) 2004;22:7019   DOI
8 Sayar A, Turna A, Solak O, Urer N, Gurses A. Prognostic significance of surgical-pathologic multistation N1 disease in non-small cell carcinoma of the lung. Eur J Cardiothorac Surg 2004;25:434-8   DOI   ScienceOn
9 Arriagata R, Bergan B, Dunant A, Le Chevalier T, Pignon JP, Vansteenkiste J. The International Adjuvant Lung Cancer Trial Collaborative Group. Cisplatin based adjuvant chemotherapy in patients with completely resected non-small cell lung cancer. N Engl J Med 2004;350:351-60   DOI   ScienceOn
10 van Velzen E, Snijder RJ, de la Riviere AB, Elbers HRJ, van den Bosch JMM. Lymph node type as a prognostic factor for survival in T2N1M0 non-small cell lung carcinoma. Ann Thorac Surg 1997;63:1436-40   DOI   ScienceOn
11 Sawyer TE, Bonner JA, Gould PM, et al. Factors predicting patterns of recurrence after resection of N1 non-small cell lung carcinoma. Ann Thorac Surg 1999;68:1171-6   DOI   ScienceOn
12 Tanaka F, Yanagihara K, Otake Y, et al. Prognostic factors in patients with resected pathologic (p) T1-2N1M0 non-small cell lung cancer. Eur J Cardio Thorac Surg 2001;19:555-561   DOI   ScienceOn
13 Travis WD, Colby TV, Corrin B, Shimosato Y, Brambilla E. World health organization international histologic classification of tumours. 3rd ed. Springer-Verlag. 1999
14 Riquet M, Manac'h D, Le Pimpec-Barthes F, Dujon A, Chehab A. Prognostic significance of surgical-pathologic N1 disease in non-small cell carcinoma of the lung. Ann Thorac Surg 1999;67:1572-6   DOI   ScienceOn
15 Keller S, Adak S, Wagner H, Johnson DH. Mediastinal lymph node dissection improves survival in patients with Stage II and IIIa non-small cell lung cancer. Ann Thorac Surg 2000;70:358-66   DOI   PUBMED   ScienceOn
16 Marra A, Hillejan L, Zaboura G, Fujimoto T, Greschuchna A, Stamatis G. Pathologic N1 non-small cell lung cancer: Correlation between pattern of lymphatic spread and prognosis. J Thorac Cardiovasc Surg 2003;125:543-53   DOI   ScienceOn
17 Winton TL, Livingston R, Johnson D, et al. A prospective randomised trial of adjuvant vinorelbine (VIN) and cisplatin (CIS) in completely resected stage IB and II non small cell lung cancer. Intergroup JBR.10. J Clin Oncol (Meeting Abstracts) 2004;22:7018   DOI
18 Ichinose Y, Yano T, Asoh H, Yokoyama H, Yoshino I, Kaysuda Y. Prognostic factors obtained by a pathologic examination in completely resected non-small cell lung cancer. An analysis in each pathologic stage. J Thorac Cadiovasc Surg 1995;110:601-5   DOI   ScienceOn
19 van Rens MTM, de la Riviere AB, Elbers HRJ, van den Bosch JMM. Prognostic assessment of 2361 patients who underwent pulmonary resection for non-small cell lung cancer, Stage I,II, and IIIA. Chest 2000;117:374-9   DOI   ScienceOn
20 Yano T, Yokoyama H, Inoue T, Asoh H, Tayama K. Ichinose Y. Surgical results and prognostic factors of pathologic N1 disease in non-small cell carcinoma of the lung. J Thorac Cardiovasc Surg 1994;107:1398-402