Mammadova Jamila, Tanvetyanon Tawee
Department of Hematology and Oncology, University of South Florida, Tampa, USA.
Department of Thoracic Oncology, Moffitt Cancer Center and Research Institute, Tampa, USA.
Cureus. 2023 Dec 30;15(12):e51354. doi: 10.7759/cureus.51354. eCollection 2023 Dec.
Ultra-late recurrence, defined as recurrence occurring 10 years or longer after curative treatment, is uncommon for non-small cell lung cancer (NSCLC). To date, factors associated with ultra-late recurrence remain unknown. We report a case with ultra-late recurrence and reviewed the literature published during 2010-2023. This is a case of a 66-year-old woman, with a significant smoking history and a previous history of lung adenocarcinoma, who underwent surgery for a brain metastasis detected on imaging. The pathology confirmed lung adenocarcinoma with an epidermal growth factor receptor (EGFR) exon 20 insertion, a finding consistent with the initial lung surgery a decade ago. With receiving intrathecal topotecan, the patient has maintained stable disease 10 months post-surgery. Given the rarity of ultra-late recurrence of NSCLC, we also conducted a pooled analysis with the outcome of interest being a time to recurrence. Data from this case report was analyzed along with previously published 26 cases of ultra-late recurrence. Multivariable analysis indicated that the only factor significantly predicting time to recurrence was anaplastic lymphoma kinase (ALK) rearrangement.
超晚期复发定义为根治性治疗后10年或更长时间出现的复发，在非小细胞肺癌（NSCLC）中并不常见。迄今为止，与超晚期复发相关的因素仍不清楚。我们报告了一例超晚期复发病例，并回顾了2010年至2023年期间发表的文献。这是一名66岁女性，有大量吸烟史且既往有肺腺癌病史，因影像学检查发现脑转移而接受手术。病理证实为肺腺癌伴表皮生长因子受体（EGFR）外显子20插入，这一发现与十年前的初次肺部手术结果一致。接受鞘内注射拓扑替康后，患者术后10个月病情保持稳定。鉴于NSCLC超晚期复发的罕见性，我们还进行了一项汇总分析，感兴趣的结果是复发时间。将本病例报告的数据与之前发表的26例超晚期复发病例的数据进行了分析。多变量分析表明，显著预测复发时间的唯一因素是间变性淋巴瘤激酶（ALK）重排。
