Author of

• 11595

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  P2.07 - Poster Session 2 - Surgery (ID 190)

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

  • 11639

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    P2.07-044 - Risk factors for recurrence after pathological stage IA non-small cell lung cancer resection (ID 3199)

    09:30 - 09:30  |  Author(s): K. Ishida
    • Abstract

    Background
    Adjuvant chemotherapy is not required for pathological stage (p-stage) IA non-small cell lung cancer (NSCLC). And the prognosis of p-stage IA NSCLC is comparatively good. In the Japanese Joint Committee for Lung Cancer Registration, the 5-year survival rate for p-stage IA NSCLC was reported with 86.8% [J Thorac Oncol 2011; 6: 1229-35]. But, there are some cases to cause recurrences more than expected among them. The purpose of this study was to evaluate the risk factors for recurrence in p-stage IA NSCLC patients who had undergone complete resection.

    Methods
    A total of 409 primary NSCLC patients underwent pulmonary resections between January 2003 and December 2012. Among them, 145 patients with p-stage IA NSCLC completely excised tumors in surgical procedures of segmentectomy or more were evaluated. All patients were divided into two groups : the group with recurrence (group R, n=15) and the group with no-recurrence (group NR, n=130). We compared the both groups regard to the patient-related factors (age, sex, smoking habits, previous history, consultation motivation, timing of definitive diagnosis), the tumor-related factors (tumor markers, histologic type and differentiation, tumor size, lymphatic permeation, vascular invasion, EGFR gene mutation) and the treatment-related factors (extent of resection and nodal dissection, thoracoscopic surgery or open thoracotomy, skill levels of operators, operative duration, amount of bleeding, postoperative hospital stay, adjuvant chemotherapy). The postoperative 5-year survival rate was calculated with the Kaplan-Meier method. The differences of significance between the two groups were compared using the Chi-square test. P values less than 0.05 were considered statistically significant.

    Results
    The 5-year survival rate was 45.0% in the group R and 92.3% in the group NR (p<0.001). In the patient-related factors, the smoker/non-smoker ratio was 7/8 in the group R and 95/35 in the group NR (p<0.05). The previous history of hypertension/no-hypertension ratio was 9/6 in the group R and 44/86 in the group NR (p<0.05) and that of diabetes/non-diabetes ratio was 4/11 in the group R and 10/120 in the group NR (p<0.05). There were no significant differences in other patient-related risk factors. In the tumor-related factors, the pathological lymphatic permeation ly1/ly0 ratio was 3/6 in the group R and 3/76 in the group NR (p<0.001). There were no significant differences in other tumor-associated risk factors. In the treatment-related factors, the enforcement of adjuvant chemotherapy/nothing ratio was 2/13 in the group R and 3/127 in the group NR (p<0.05). There were no significant differences in other treatment-related risk factors.

    Conclusion
    A history of hypertension or diabetes, lymphatic permeation and adjuvant chemotherapy were risk factors for recurrence, respectively. And aggressive enforcement of adjuvant chemotherapy is desirable in p-stage IA NSCLC patients both with pathologically lymphatic permeation and with a history of diabetes or hypertension.