Post-recurrence survival in completely resected stage I non-small cell lung cancer with local recurrence
Post-recurrence survival in completely resected stage I non-small cell lung cancer with local recurrence
复制标题
DOI：
10.1136/thx.2007.094912
复制
发表时间：
2009-03-01
期刊：
影响因子：
10
通讯作者：
Wu, Y-C
中科院分区：
文献类型：
--
作者：
Hung, J-J;Hsu, W-H;Wu, Y-C
目的：手术切除是非小细胞肺癌（NSCLC）的最佳治疗方法。一期非小细胞肺癌完全切除后疾病复发的模式尚未得到很好的证实。本研究的目的是评估局部复发的切除I期NSCLC患者复发后生存的预后预测因素。方法：回顾性分析1980 ~ 2000年台北荣民总医院一期非小细胞肺癌全切除术后局部复发的123例患者的临床病理特点。分析复发后生存率及其预测因素。结果：局部复发类型仅为局部74例（60.2%），局部和远处兼有49例（39.8%）。74例局部复发患者的1年和2年生存率分别为48.7%和17.6%。在单因素分析中，肿瘤大小（p= 0.033）和初始复发治疗（p < 0.001）是74例局部复发患者复发后生存的重要预测因素。肿瘤大小较大的患者死亡风险更大。在多变量分析中，初始复发治疗（p= 0.001）仍然是一个重要的预后指标。局部复发后再手术的患者比接受化疗和/或放疗和未接受治疗的患者存活时间更长。结论：初始复发治疗是局部复发切除的I期NSCLC复发后生存的预后预测因素。对于可切除的局部复发性疾病，应考虑完全手术切除。
Objective: Resection is the best treatment for patients with stage I non-small cell lung cancer (NSCLC). Patterns of disease recurrence after complete resection in stage I NSCLC have not been well demonstrated. The aim of this study was to evaluate the prognostic predictors of post-recurrence survival in patients with resected stage I NSCLC with local recurrence.Methods: The clinicopathological characteristics of 123 patients with local recurrence after complete resection of stage I NSCLC in Taipei Veterans General Hospital between 1980 and 2000 were retrospectively reviewed. Post-recurrence survival and their predictors were analysed.Results: The patterns of local recurrence included local only in 74 (60.2%) and both local and distant in 49 (39.8%) patients. The 1 and 2 year post-recurrence survival rates for the 74 patients with local only recurrence were 48.7% and 17.6%, respectively. Tumour size (p= 0.033) and treatment for initial recurrence (p < 0.001) were significant predictors for post-recurrence survival in 74 patients with local only recurrence in univariate analyses. The hazard of death was greater in patients with larger tumour size. Treatment for initial recurrence (p= 0.001) was still a significant prognostic indicator in multivariate analyses. Patients who underwent reoperation after local recurrence survived longer than those who received chemotherapy and/or radiotherapy and those that received no treatment.Conclusions: Treatment for initial recurrence is a prognostic predictor for post-recurrence survival in resected stage I NSCLC with local recurrence. Complete surgical resection should be considered in selected candidates with resectable local recurrent disease.