Characteristics and timing of recurrence during postoperative surveillance after curative resection for lung adenocarcinoma
| Autor: | Osamu Namura, Terumoto Koike, Masashi Takahashi, Tatsuya Goto, Masayuki Saitoh, Shin-ichi Toyabe, Masanori Tsuchida, Akihiko Kitahara, Takehisa Hashimoto, Seijiro Sato |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Lung Neoplasms Time Factors Disease Adenocarcinoma 030204 cardiovascular system & hematology 03 medical and health sciences Sex Factors 0302 clinical medicine Risk Factors Surgical oncology Internal medicine Cytology medicine Humans Postoperative Period Risk factor Aged Neoplasm Staging Retrospective Studies Aged 80 and over Framingham Risk Score Lung business.industry Retrospective cohort study General Medicine Middle Aged medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Epidemiological Monitoring Pleura Female Surgery Radiology Neoplasm Recurrence Local Tomography X-Ray Computed business Bronchoalveolar Lavage Fluid Follow-Up Studies |
| Zdroj: | Surgery Today. 47:1469-1475 |
| ISSN: | 1436-2813 0941-1291 |
| DOI: | 10.1007/s00595-017-1537-3 |
| Popis: | To establish the most effective methods of postoperative surveillance to detect early recurrence of lung adenocarcinoma. The subjects of this retrospective study were 485 patients with p-stage I–III lung adenocarcinoma, who underwent postoperative surveillance. We examined the sites and detection modes of recurrence and calculated the recurrence-free probabilities. Patients with stage I disease were divided into low- and high-risk recurrence groups using a risk score calculated by assigning points proportional to risk factor regression coefficients. Of the 112 patients with recurrence, 86 had intrathoracic recurrence. Routine computed tomography (CT) revealed recurrence in 60 patients. The recurrence-free probability curves showed that 95% of recurrences were identified within the first 4 years after resection in patients with stage II/III disease. In patients with stage I disease, the predictors of recurrence included male sex, positive pleural lavage cytology, moderate-to-poor differentiation, and visceral pleural invasion. Postoperative recurrences were detected throughout the follow-up period in the high-risk group. Routine chest CT plays an important role in the postoperative surveillance of lung adenocarcinoma. We recommend intensive follow-up during the early post-resection period for patients with advanced stage disease and long-term follow-up for high-risk patients with stage I disease. |
| Databáze: | OpenAIRE |
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