Time-varying pattern of postoperative recurrence risk of early-stage (T1a-T2bN0M0) non-small cell lung cancer (NSCLC): results of a single-center study of 994 Chinese patients.
Time-varying pattern of postoperative recurrence risk of early-stage (T1a-T2bN0M0) non-small cell lung cancer (NSCLC): results of a single-center study of 994 Chinese patients.
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DOI：
10.1371/journal.pone.0106668
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zhang LJ
中科院分区：
文献类型：
--
作者：
Zhu JF;Feng XY;Zhang XW;Wen YS;Lin P;Rong TH;Cai L;Zhang LJ
本研究的目的是使用风险函数分析手术后早期（T1 a-T2 bN 0 M0）非小细胞肺癌（NSCLC）复发风险的时间变化模式，并确定可能从辅助化疗中获益的患者。这项回顾性研究纳入了1999年1月至2009年10月期间接受根治性手术切除的994例早期NSCLC患者。使用Kaplan-Meier方法生成生存曲线，并使用风险函数估计年复发风险。中位无复发生存期（RFS）为8.8年。生命表生存分析显示1年、3年、5年和10年复发率分别为82.0%、67.0%、59.0%和48.0%。约256例（25.7%）患者发生复发[局部：32例（3.2%）和远处：224例（22.5%）]，162例患者死于癌症。整个人群的年复发风险曲线显示，第一次重大复发高峰在手术后1.6年达到最大值。曲线随后下降，直到达到7.2年的最低点。第二个高峰出现在8.8岁。临床病理因素的分析表明，这种双峰模式存在于几个亚组。双峰模式的存在表明早期NSCLC的复发风险存在可预测的时间分布。年复发风险可能是选择复发风险高的患者的有效方法，这些患者可能从辅助治疗中获益。
The aim of this study was to analyze the time-varying pattern of recurrence risk of early-stage (T1a-T2bN0M0) non-small cell lung cancer (NSCLC) after surgery using the hazard function and identify patients who might benefit from adjuvant chemotherapy. This retrospective study enrolled 994 patients with early-stage NSCLC who underwent radical surgical resection between January 1999 and October 2009. Survival curves were generated using the Kaplan-Meier method, and the annual recurrence hazard was estimated using the hazard function. The median recurrence-free survival (RFS) was 8.8 years. The life table survival analysis showed that the 1-year, 3-year, 5-year and 10-year recurrence rates were 82.0%, 67.0%, 59.0% and 48.0%, respectively. Approximately 256 (25.7%) patients experienced relapse [locoregional: 32 (3.2%) and distant: 224 (22.5%)], and 162 patients died from cancer. The annual recurrence hazard curve for the entire population showed that the first major recurrence surge reached a maximum 1.6 years after surgery. The curve subsequently declined until reaching a nadir at 7.2 years. A second peak occurred at 8.8 years. An analysis of clinical-pathological factors demonstrated that this double-peaked pattern was present in several subgroups. The presence of a double-peaked pattern indicates that there is a predictable temporal distribution of the recurrence hazard of early-stage NSCLC. The annual recurrence hazard may be an effective method of selecting patients at high risk of recurrence, who may benefit from adjuvant therapy.
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