Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Department of Thoracic Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
Thorac Cancer. 2020 Nov;11(11):3280-3288. doi: 10.1111/1759-7714.13669. Epub 2020 Sep 22.
The prognosis of postoperative recurrence in patients with non-small cell lung cancer (NSCLC) is poor. However, depending on the recurrence patterns and treatment options, some patients can achieve long-term survival following recurrence. In this study, we investigated the clinicopathological characteristics of NSCLC patients with curable disease who developed postoperative recurrence.
This retrospective study enrolled 535 patients who had developed recurrence from among 1760 consecutive patients with NSCLC who underwent curative resection from 1990 to 2008. Post-recurrence cure was defined as being cancer-free for at least five years after treatment for recurrence in patients who had undergone radical local treatment or chemotherapy. The clinicopathological characteristics associated with post-recurrence cure were analyzed.
Among 535 patients who developed recurrence, 24 (4.5%) achieved post-recurrence cure. The median post-recurrence follow-up duration was 151 (85-275) months for those who achieved post-recurrence cure. The solitary recurrent lesions and local treatment for the initial recurrence site were significantly more for patients who could be cured after they developed recurrence. All patients with post-recurrence cure received only radical local treatment for the recurrent lesions.
Some patients with solitary recurrent NSCLC lesions can be cured with only radical local treatment.
Significant findings of the study The post-recurrence cure patients maintained a cancer-free status for five years after treatment for recurrence without a second recurrence. All patients with post-recurrence cure received only radical local treatment for recurrence and had significantly higher number of solitary recurrent lesions. What this study adds Some patients with solitary recurrent NSCLC lesions after resection can be cured with only radical local treatment.
非小细胞肺癌（NSCLC）患者术后复发的预后较差。然而，根据复发模式和治疗选择，一些患者在复发后可以实现长期生存。本研究旨在探讨可治愈疾病的 NSCLC 患者术后复发的临床病理特征。
本回顾性研究纳入了 1990 年至 2008 年间连续接受根治性切除术的 1760 例 NSCLC 患者中 535 例出现复发的患者。在接受根治性局部治疗或化疗的患者中，在治疗复发后至少五年无癌生存定义为复发后治愈。分析与复发后治愈相关的临床病理特征。
在 535 例复发患者中，24 例（4.5%）实现了复发后治愈。复发后治愈患者的中位随访时间为 151（85-275）个月。对于复发后可治愈的患者，孤立性复发病灶和初始复发病灶的局部治疗明显更多。所有复发后治愈的患者仅接受复发病灶的根治性局部治疗。
对于孤立性复发性 NSCLC 病变，仅采用根治性局部治疗可能治愈部分患者。
研究的重要发现 治愈的患者在接受复发性疾病治疗后五年内无癌生存，无第二次复发。所有复发后治愈的患者仅接受复发病灶的根治性局部治疗，且复发性病变的孤立性数目明显更多。 本研究增添的内容 对于可切除 NSCLC 患者术后孤立性复发，仅采用根治性局部治疗可能治愈部分患者。
