Author of

• 15301

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  P3.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 211)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Localized Disease - NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15302

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    P3.02-001 - Factors Affecting Tumor Recurrence in Early Stage Non-Small Cell Lung Cancer (ID 459)

    09:30 - 09:30  |  Author(s): Y. Castro
    • Abstract

    Background:
    For early stage non-small cell lung cancer (NSCLC) surgery is potentially the only curative treatment. However, a proportion of lung cancer patients develop recurrence, even after complete resection. The factors affecting recurrence in these patients are largely unknown. This study aimed to identify the predictive factors for recurrence in patients with stage I/II NSCLC.
    
    Methods:
    We retrospectively reviewed all patients diagnosed with stage I/II NSCLC at our institution from 2000 to 2013. Initial diagnosis at our institution and a minimum follow up of 36 months were required. Cox regression model was used for multivariate analysis.
    
    Results:
    A total of 673 patients with stage I/II were identified, of those 175 (26%) developed local or distant recurrence, with a median time to recurrence of 18 months. Median age was 74 (range: 44-96 years), 56% were current or former smokers. Patients were more likely to have upper lobe tumors than all other tumor locations combined (58% vs 42%), adenocarcinoma was the most prevalent histologic subtype (53%) and 47% had poorly differentiated or anaplastic tumors. 152 patients (87%) received surgery with lobectomy being the most common procedure followed by wedge resection. 24% received chemotherapy and 7% radiation. Median overall survival was 26 months (95%CI: 17.2-34.5). Patients with squamous cell carcinoma had a shorter median time to recurrence when compared with adenocarcinomas (13.2 months vs. 19.7 months) (p<0.02). Smoking history (HR: 1.98, 95%CI: 1.62-2.82, p<0.007), central tumor location (HR: 1.24, 95%CI: 1.09-1.56, p<0.01), squamous subtype (HR: 1.46, 95%CI: 1.22-1.84, p<0.002) , high histologic grade (HR: 2.76, 95%CI: 1.34-5.97, p<0.01) and lymphovascular invasion (HR: 4.3, 95%CI: 3.32-5.00, p<0.001) were independent predictors of recurrence by multivariate analysis. Poorly differentiated tumors were associated with a higher frequency of distant recurrence when compared with well differentiated tumors (OR: 2.7 vs. 1.2). In 43% of the patients with recurrence lung cancer was the primary cause of death.
    
    Conclusion:
    In our cohort, we observed that patients with lymphovascular invasion have the highest recurrence risk followed by high histologic grade tumors with the former having a direct correlation with distant metastasis. Patients with these risk factors may benefit from close surveillance after surgical resection, adjuvant therapy and aggressive management of local recurrence.