Sonoda Dai, Matsuura Yosuke, Ichinose Junji, Nakao Masayuki, Ninomiya Hironori, Mun Mingyon, Ishikawa Yuichi, Nakagawa Ken, Satoh Yukitoshi, Okumura Sakae
Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan.
Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan.
Cancer Manag Res. 2019 Jul 19;11:6765-6774. doi: 10.2147/CMAR.S213553. eCollection 2019.
Most postoperative recurrences of non-small cell lung cancer (NSCLC) develop within 5 years after curative resection, with ultra-late recurrences developing over 10 years after the resection being rare. This study aimed to analyze the features of ultra-late recurrence in cases with NSCLC who had undergone curative resection.
Among 1458 consecutive cases with NSCLC who underwent curative resection with systematic lymph node dissection during 1990-2006, 12 cases developed recurrence over 10 years after the resection. We defined the recurrence developing over 10 years after the resection as ultra-late recurrence and analyzed the factors related to it.
Among the 1458 cases, recurrence developed in 476 (32.6%) cases. Of them, ultra-late recurrence developed in 12 (2.5%) cases. The ultra-late recurrence was histopathologically classified as adenocarcinoma in 11 cases and atypical carcinoid in 1 case. All cases were of invasive carcinoma. We compared ultra-late recurrence cases with non-recurrence cases and showed that none of the examined factors significantly influenced ultra-late recurrence; however, lymphatic invasion was close to significantly influencing it. There were two cases in which recurrence developed over 15 years after the resection; both cases were of adenocarcinoma with anaplastic lymphoma kinase (ALK) rearrangement.
There is a possibility of ultra-late recurrence developing over 10 years after the resection of any invasive NSCLC. Lymphatic invasion is close to significantly influencing ultra-late recurrence. Furthermore, a long follow-up period may be required in cases with adenocarcinoma with ALK rearrangement because it has the possibility of recurrence over 15 years after the resection.
大多数非小细胞肺癌（NSCLC）术后复发发生在根治性切除后的5年内，切除10年后出现的超晚期复发很少见。本研究旨在分析接受根治性切除的NSCLC患者超晚期复发的特征。
在1990 - 2006年期间连续1458例接受根治性切除并系统性淋巴结清扫的NSCLC患者中，有12例在切除10年后出现复发。我们将切除10年后出现的复发定义为超晚期复发，并分析与之相关的因素。
在1458例患者中，476例（32.6%）出现复发。其中，12例（2.5%）出现超晚期复发。超晚期复发在组织病理学上11例为腺癌，1例为非典型类癌。所有病例均为浸润性癌。我们将超晚期复发病例与未复发病例进行比较，结果显示所检查的因素均未对超晚期复发产生显著影响；然而，淋巴管侵犯接近显著影响超晚期复发。有2例在切除15年后出现复发；这2例均为具有间变性淋巴瘤激酶（ALK）重排的腺癌。
任何浸润性NSCLC切除10年后都有可能出现超晚期复发。淋巴管侵犯接近显著影响超晚期复发。此外，对于具有ALK重排的腺癌患者可能需要更长的随访期，因为其在切除15年后仍有可能复发。
