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Predictors of Recurrence after Curative Resection in Patients with Early-Stage Non-Small Cell Lung Cancer

결핵및호흡기질환
2015년 78권 4호 p.341 ~ p.348
이상희 ( Lee Sang-Hee ) - Wonkwang University Sanbon Hospital Department of Internal Medicine

조은정 ( Jo Eun-Jung ) - Pusan National University Hospital Department of Internal Medicine
엄중섭 ( Eom Jung-Seop ) - Pusan National University Hospital Department of Internal Medicine
목정하 ( Mok Jeong-Ha ) - Pusan National University Hospital Department of Internal Medicine
김미현 ( Kim Mi-Hyun ) - Pusan National University Hospital Department of Internal Medicine
이광하 ( Lee Kwang-Ha ) - Pusan National University Hospital Department of Internal Medicine
김기욱 ( Kim Ki-Uk ) - Pusan National University School of Medicine Department of Internal Medicine
박혜경 ( Park Hye-Kyung ) - Pusan National University Hospital Department of Internal Medicine
이창훈 ( Lee Chang-Hun ) - Pusan National University Hospital Department of Pathology
김영대 ( Kim Yeong-Dae ) - Pusan National University Hospital Department of Thoracic and Cardiovascular Surgery
이민기 ( Lee Min-Ki ) - Pusan National University Hospital Department of Internal Medicine

Abstract

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.

Conclusion : 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.

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