Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer.
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.
Maeda
Ryo
R
Department 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.
Yoshida
Junji
J
Ishii
Genichiro
G
Aokage
Keiju
K
Hishida
Tomoyuki
T
Nishimura
Mitsuyo
M
Nishiwaki
Yutaka
Y
Nagai
Kanji
K
D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery*; D000368:Aged; D018287:Carcinoma, Large Cell / Q000556:secondary / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011013:Pneumonectomy; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome