Prognostic factors for post-recurrence survival in patients with completely resected Stage III (N2) non-small-cell lung cancer

• Published in: European journal of cardio-thoracic surgery 2018-09, Vol.54 (3), p.554-559
• Main Authors: Cho, Sukki, Yum, Sungwon, Kim, Kwhanmien, Jheon, Sanghoon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - epidemiology; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - surgery; Female; Humans; Kaplan-Meier Estimate; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Male; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - surgery; Pneumonectomy - mortality; Prognosis; Retrospective Studies
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezy063

The aim of this study was to investigate the prognostic factors for post-recurrence survival (PRS) in patients with completely resected Stage III (N2) non-small-cell lung cancer. A number of clinicopathological factors were evaluated to identify the prognostic factors for recurrence-free survival using Cox proportional hazards models in 245 patients who underwent complete resection of pathological Stage III (N2) non-small-cell lung cancer. Additional post-recurrence data were evaluated, including the presence of symptoms of recurrence, the recurrence pattern, the treatment modality and the recurrence-free interval (RFI). The prognostic effects of clinicopathological factors before recurrence and the additional post-recurrence data on PRS were analysed. A total of 124 patients experienced recurrence during a median follow-up period of 39.8 months. Twenty-one patients were symptomatic at the time of initial recurrence, and the mean RFI was 14.0 months. Loco-regional recurrence was observed in 38 (31%) patients, distant metastasis in 33 (27%) patients and both in 53 (42%) patients. The initial treatment modality was surgery in 17 (14%) patients, chemotherapy in 66 (53%) patients, radiotherapy in 17 (14%) patients and chemoradiotherapy in 18 (15%) patients. The median duration of PRS was 30.5 months (range 1-109 months), and the 1-, 3- and 5-year PRS rates were 72%, 43% and 23%, respectively. A shorter RFI and radiotherapy for the treatment of recurrence were found to be independent prognostic factors for PRS in the multivariable analysis. The prognostic factors for recurrence-free survival were not associated with PRS, and a shorter RFI and radiotherapy for the treatment of recurrence were found to be negative prognostic factors for PRS.