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Published on: February 12, 2017
Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer
Ryo Maeda1, Junji Yoshida, Genichiro Ishii
1Department of Thoracic Oncology, National Cancer Center Hospital East, and daggerDepartment of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Background:
The purpose of this study was to quantify the risk of late recurrence in patients with stage IA non-small cell lung cancer (NSCLC) who remained recurrence-free for more than 5 years after resection.
Methods:
Between August 1992 and December 2002, a total of 519 patients with stage IA NSCLC underwent complete resection at our institution. Recurrence-free probability was measured from the benchmark of 5 years after primary tumor resection to the date of first recurrence or last follow-up using the Kaplan-Meier method.
Results:
Of a total of 519 patients, 434 remained recurrence-free for 5 years. Among these, 21 (4.8%) developed late recurrence more than 5 years after resection. Recurrence-free interval ranged from 1 to 53 months, and the median recurrence-free interval was 14 months from the benchmark of 5 years after primary tumor resection. The 5-year recurrence-free probability from the benchmark was 93%. Multivariate Cox analysis demonstrated that vascular invasion significantly influenced late recurrence (p = 0.038). The 5-year recurrence-free probability from the benchmark was 84% for patients with vascular invasion and 95% for patients without vascular invasion (p < 0.001).
Conclusions:
Patients with stage IA NSCLC with vascular invasion harbor a significant risk of late recurrence more than 5 years after complete resection. In patients with stage IA NSCLC with vascular invasion, 5 years without recurrence is not sufficient to conclude that NSCLC is cured. In contrast, patients without vascular invasion may be declared to be cured at 5 years after resection if they are recurrence-free.
