Impact of timing and initial recurrence site on post-recurrence survival in resected non-small cell lung cancer.

Autor: Akamine T; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Takenaka T; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: takenaka.tomoyoshi.473@m.kyushu-u.ac.jp., Yano T; Department of General Thoracic Surgery, NHO Beppu Medical Centre, Beppu, Japan., Okamoto T; Department of General Thoracic Surgery, NHO Beppu Medical Centre, Beppu, Japan., Yamazaki K; Department of Thoracic Surgery, NHO Kyushu Medical Centre, Fukuoka, Japan., Hamatake M; Department of Thoracic Surgery, Kitakyushu Municipal Medical Centre, Kitakyushu, Japan., Kinoshita F; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Kohno M; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Shimokawa M; Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Japan., Yoshizumi T; Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Sep; Vol. 50 (9), pp. 108374. Date of Electronic Publication: 2024 May 03.
DOI: 10.1016/j.ejso.2024.108374
Abstrakt: Introduction: High recurrence rate following curative surgery for non-small cell lung cancer (NSCLC) presents a major clinical challenge. Understanding the site and timing of recurrence and their impact on post-recurrence survival (PRS) is important for optimal postoperative surveillance and therapeutic intervention. In this study, we investigated the influence of the time to recurrence (TTR) and initial recurrence site on PRS.
Materials and Methods: This multicentre prospective cohort study included patients who experienced recurrence after NSCLC resection between 2010 and 2015. The relationship between TTR and initial recurrence site, and their impact on PRS, was further evaluated. The hazard ratio (HR) for PRS was analysed using the Cox proportional hazards model.
Results: Among 495 patients, the median TTR was 14 (range, 1-158) months; the mode of recurrence was 11 months. Early recurrence within 6 months was observed in 17 % of patients, and 68 % of patients showed recurrence within 2 years post-surgery. The HR for PRS was the highest in patients with a TTR within 6 months, and a noticeable decline was observed after the first 6 months. The HRs of TTRs beyond 2 years were not significantly different. The liver was a significantly unfavourable prognostic site for metastases (HR 2.2; P = 0.01), and metastases frequently recurred within 6 months after surgery. The timing of brain metastasis did not significantly impact the PRS.
Conclusion: Earlier recurrence after surgery was associated with shorter PRS. In contrast, recurrences occurring >2 years after surgery do not significantly affect PRS.
Competing Interests: Declaration of competing interest All authors declare no conflicts of interest.
(© 2024 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze: MEDLINE
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