Author of

• 11794

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  P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11797

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    P2.12-003 - Postoperative recurrence and the personalized postoperative surveillance for resected lung cancer patients (ID 367)

    09:30 - 09:30  |  Author(s): N. Kanauchi
    • Abstract

    Background
    Half of the patients who have a complete lung cancer resection have a recurrence. However, advances in radiographic modalities and chemotherapy enable physicians to achieve better outcomes for postoperative lung cancer recurrence. Yet, for cases with recurrence, postoperative follow-up methods have not been adequately assessed and there is currently no evidence-based postoperative surveillance method. We evaluated cases with postoperative recurrence and the personalized postoperative surveillance periods and methods used.

    Methods
    Follow-up after surgery consisted of a regular outpatient clinic check-up, including physical examination, history taking, blood tests, and chest X-ray, which were done three or four times per year for five years. During the follow-up period, annual chest and brain computed tomography scanning was done. If the patients were completely followed for 5 years, then surviving patients continued to be followed using chest X-ray or CT. Between May 2004 and December 2011, 547 patients had completely resected lung cancers in our institution. We retrospectively reviewed their prospectively collected database.

    Results
    We selected 106 patients (19.4%) who had a postoperative recurrence for an analysis of associations between recurrence and clinical factors. Regarding pathological stages, 24 of 257 (9.3%) with stage IA, 23 of 115 (20.0%) with stage IB, 18 of 61 (29.5%) with stage IIA, 10 of 25 (40.0%) with stage, IIB 30 of 50 (60.0%) with stage IIIA, and 1 of 2 (50.0%) with stage IV developed a recurrence. Sixty-eight patients (64%) were found to have a recurrence during follow-up surveillance and 38 patients (36%) were found to have a recurrence based on symptoms. The median time to recurrence was 12 months (1–72 months). Cumulative recurrence rates after surgery were 53% at 1 year, 81% at 2 years, and 98% at 5 years. Multivariate analysis showed that an advanced stage (stage II-IV; p < 0.01) and lymphovascular invasion positive (LVI; p = 0.01) were independent factors for earlier recurrence. Comparing those patients who were advanced stage and LVI positive with those who did not have these factors, 90.8% of high-risk patients had a relapse and 55.1.% of the other patients had a relapse within 2 years after surgery (p < 0.01). Five-year survival after surgery for patients with recurrence was 31.6% and 5-year survival after recurrence was 9.0%. Multivariate analysis showed that recurrence with symptoms (p < 0.01) and shorter time to recurrence (< 24 months; p < 0.01) were independent prognostic factors after recurrence.

    Conclusion
    Although this study was retrospective and included some biases, advanced stage and LVI positive patients should be intensively followed-up. Personalized follow-up programs for resected lung cancer patients should be considered.