Predictors of Recurrence after Curative Resection in Patients with Early-Stage Non-Small Cell Lung Cancer.
BACKGROUND
There have been various results from studies concerning the predictors of recurrence in early-stage nonsmall cell lung cancer (NSCLC). Therefore, an accurate assessment is needed to guide effective adjuvant therapy. We investigated the predictors of a recurrence in patients with resected, early-stage NSCLC and the risk factors associated with locoregional or distant recurrence.


METHODS
This retrospective study was conducted on patients at the Pusan National University Hospital from January 2006 to December 2011. Patients with pathological stages I or II were included in this study, as based on the seventh edition TNM staging system. Multivariate Cox proportional hazard models were used to identify factors associated with recurrence.


RESULTS
Two hundred and forty-nine patients were included. Among them, 180 patients were stage I, and 69 were stage II. Overall, by multivariate analysis, the independent factors associated with a 5-year total recurrence were the presence of visceral pleural invasion (VPI) (p=0.018) and maximal standardized uptake values (SUVs) of tumors on positron emission tomography (PET) >4.5 (p=0.037). The VPI was the only independent risk factor associated with both locoregional and distant recurrence, in the analysis of the patterns of tumor recurrence and their risk factors. In the subgroup analysis of stage I patients, three variables (male, VPI and resection margin positive) were significantly associated with a 5-year recurrence.


CONCLUSIONS
The independent factors associated with postoperative recurrence in early-stage NSCLC were as follows: PET SUV >4.5 and the presence of VPI. For patients with those factors adjuvant therapy should be recommended as a more efficacious treatment.
Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
Sang Hee
SH
Lee
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Eun Jung
EJ
Jo
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Jung Seop
JS
Eom
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Jeong Ha
JH
Mok
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Mi Hyun
MH
Kim
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Kwangha
K
Lee
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Ki Uk
KU
Kim
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Hye-Kyung
HK
Park
Department of Pathology, Pusan National University Hospital, Busan, Korea.
Chang Hun
CH
Lee
Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Korea.
Yeong Dae
YD
Kim
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Min Ki
MK
Lee
Adjuvants; Carcinoma, Non-Small-Cell Lung; Drug Therapy; Recurrence