Matsumura Yuki, Yano Motoki, Yoshida Junji, Koike Terumoto, Kameyama Kotaro, Shimamoto Akira, Nishio Wataru, Yoshimoto Kentaro, Utsumi Tomoki, Shiina Takayuki, Watanabe Atsushi, Yamato Yasushi, Watanabe Takehiro, Takahashi Yusuke, Sonobe Makoto, Kuroda Hiroaki, Oda Makoto, Inoue Masayoshi, Tanahashi Masayuki, Adachi Hirofumi, Saito Masao, Hayashi Masataro, Otsuka Hajime, Mizobuchi Teruaki, Moriya Yasumitsu, Takahashi Mamoru, Nishikawa Shigeto, Suzuki Hiroyuki
Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan Division of Chest Surgery, Fukushima Medical University, Fukushima, Japan
Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Interact Cardiovasc Thorac Surg. 2016 Sep;23(3):444-9. doi: 10.1093/icvts/ivw125. Epub 2016 May 25.
In 2015, we reported the outcomes of patients undergoing intentional limited resection (ILR) for non-small-cell lung cancer (NSCLC) from a retrospective, multi-institutional large database in Japan. Here, we analyse the clinicopathological characteristics of the patients extracted from this database with late recurrence and compare them with those with early recurrence.
Of 1538 patients in the database with cT1aN0M0 NSCLC, 92 (6%) had recurrence. In this study, early recurrence was defined as recurrence within 5 years and late recurrence as recurrence beyond 5 years after surgery. We compared the clinicopathological characteristics and post-recurrence survival (PRS) between patients with early and late recurrence.
Of the 92 patients with recurrence, 21 (23%) had late recurrence. Compared with the early recurrence group, there were significantly more adenocarcinomas and local recurrences in the late recurrence group (P = 0.04 for both). The 3- and 5-year PRS rates were 53 and 24%, respectively, and the median PRS period was 38 months. There were no significant differences in the PRS curves between patients with early and late recurrence (P = 0.12). Only 3 patients (0.2%) had recurrence more than 10 years after ILR. Of the 21 late-recurrence patients, 17 (81%) had tumours with a consolidation/tumour ratio (CTR) >0.25.
Late recurrence occurred in 21 (23%) of 92 patients with recurrence after ILR for cT1aN0M0 NSCLC. Late recurrence was more likely to involve adenocarcinoma and local recurrence. It is thus considered reasonable to follow patients with a CTR >0.25 for 10 years after ILR.
2015年，我们报告了来自日本一项回顾性、多机构大型数据库中接受非小细胞肺癌（NSCLC）意向性局限性切除术（ILR）患者的治疗结果。在此，我们分析从该数据库中提取的晚期复发患者的临床病理特征，并将其与早期复发患者的特征进行比较。
数据库中1538例cT1aN0M0 NSCLC患者中，92例（6%）出现复发。在本研究中，早期复发定义为术后5年内复发，晚期复发定义为术后5年以上复发。我们比较了早期和晚期复发患者的临床病理特征及复发后生存率（PRS）。
92例复发患者中，21例（23%）为晚期复发。与早期复发组相比，晚期复发组腺癌和局部复发明显更多（两者P均=0.04）。3年和5年PRS率分别为53%和24%，PRS中位期为38个月。早期和晚期复发患者的PRS曲线无显著差异（P = 0.12）。ILR术后10年以上仅3例（0.2%）复发。21例晚期复发患者中，17例（81%）肿瘤的实变/肿瘤比（CTR）>0.25。
cT1aN0M0 NSCLC患者ILR术后92例复发患者中有21例（23%）出现晚期复发。晚期复发更易累及腺癌和局部复发。因此，对于CTR>0.25的患者，ILR术后随访10年被认为是合理的。
