Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 8/2014

01.08.2014 | Thoracic Oncology

Identification of Subsets of Patients with Favorable Prognosis After Recurrence in Completely Resected Non-Small Cell Lung Cancer

verfasst von: Makoto Sonobe, MD, PhD, Tetsu Yamada, MD, PhD, Masaaki Sato, MD, PhD, Toshi Menju, MD, PhD, Akihiro Aoyama, MD, PhD, Toshihiko Sato, MD, PhD, Fengshi Chen, MD, PhD, Mitsugu Omasa, MD, PhD, Toru Bando, MD, PhD, Hiroshi Date, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

This retrospective study aimed to determine prognostic factors associated with postrecurrence survival of completely resected non-small cell cancer patients with postoperative recurrence.

Methods

Characteristics, treatment modality, and postrecurrence survival of 234 patients (157 males and 77 females, mean age at recurrence: 68.7 years, 152 adenocarcinomas and 82 non-adenocarcinomas), who underwent complete resection for non-small cell lung cancer between 2003 and 2009 at our hospital and experienced recurrence, were analyzed for prognostic factors. Cox proportional hazard model was applied for multivariate analysis.

Results

Among 234 patients, the median survival time after the diagnosis of recurrence was 21 months, and the 5-year postrecurrence survival rate was 19.9 %. Eastern Cooperative Oncology Group Performance Status (ECOG PS) (hazard ratio [HR]: ECOG PS-0/PS-1/PS-2 = 1/3.313/7.622), time to recurrence after surgery (HR: >2 years/1–2 years/<1 year = 1/1.881/2.185), and number of initial recurrent organs (HR: 1 organ/2 organs/3 or more organs = 1/1.896/2.818) were independent prognostic factors. Patients who received resection or stereotactic irradiation for limited number of brain metastases or solitary extracranial metastasis, and those who received mediastinal radiation or chemoradiation for recurrence at regional lymph nodes and/or resected stump had better survival (median survival time after recurrence: 34, 64, and 25 months, respectively).

Conclusions

Poor ECOG PS, shorter time from initial surgery to recurrence, and increasing number of initial recurrent regions are associated with poor prognosis after recurrence. When the number of recurrent lesions is limited, intensive local treatment with curative intent should be applied for achieving long-term postrecurrence survival.
Literatur
1.
Sawabata N, Miyaoka E, Asamura H, Nakanishi Y, Eguchi K, Mori M, et al. Japanese Joint Committee for Lung Cancer Registration., Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol. 2011;6:1229–35.
2.
Williams BA, Sugimura H, Endo C, Nichols FC, Cassivi SD, Allen MS, et al. Predicting postrecurrence survival among completely resected nonsmall-cell lung cancer patients. Ann Thorac Surg. 2006;81:1021–7.PubMedCrossRef
3.
Sugimura H, Nichols FC, Yang P, Allen MS, Cassivi SD, Deschamps C, et al. Survival after recurrent nonsmall-cell lung cancer after complete pulmonary resection. Ann Thorac Surg. 2007;83:409–17.PubMedCrossRef
4.
Shimada Y, Saji H, Yoshida K, Kakihana M, Honda H, Nomura M, et al. Prognostic factors and the significance of treatment after recurrence in completely resected stage I non-small cell lung cancer. Chest. 2013;143:1626–34.PubMed
5.
Non-Small Cell Lung Cancer Collaborative Group. Chemotherapy and supportive care versus supportive care alone for advanced non-small cell lung cancer. Cochrane Database Syst Rev. 12 May 2010:5:CD007309. doi:10.​1002/​14651858.
6.
Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol. 1995;13:8–10.PubMed
7.
8.
Yano T, Haro A, Yoshida T, Morodomi Y, Ito K, Shikada Y, et al. Prognostic impact of local treatment against postoperative oligometastases in non-small cell lung cancer. J Surg Oncol. 2010;102:852–5.PubMedCrossRef
9.
Okubo K, Bando T, Miyahara R, Sakai H, Shoji T, Sonobe M, et al. Resection of pulmonary metastasis of non-small cell lung cancer. J Thorac Oncol. 2009;4:203–7.PubMedCrossRef
10.
Salah S, Tanvetyanon T, Abbasi S. Metastatectomy for extra-cranial extra-adrenal non-small cell lung cancer solitary metastases: systematic review and analysis of reported cases. Lung Cancer. 2012;75:9–14.PubMedCrossRef
11.
Kavanagh BD, McGarry RC, Timmerman RD. Extracranial radiosurgery (stereotactic body radiation therapy) for oligometastases. Semin Radiat Oncol. 2006;16:77–84.PubMedCrossRef
12.
Flannery TW, Suntharalingam M, Regine WF, Chin LS, Krasna MJ, Shehata MK, et al. Long-term survival in patients with synchronous, solitary brain metastasis from non-small-cell lung cancer treated with radiosurgery. Int J Radiat Oncol Biol Phys. 2008;72:19–23.PubMedCrossRef
13.
Kawabe T, Phi JH, Yamamoto M, Kim DG, Barfod BE, Urakawa Y. Treatment of brain metastasis from lung cancer. Prog Neurol Surg. 2012;25:148–55.PubMedCrossRef
14.
Colby TV, Noguchi M, Henshke C, Vazquez MF, Geisinger K, Yokose T, et al. Adenocarcinoma. In: Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC, eds. World Health Organization classification of tumours: pathology and genetics of tumours of the lung, pleura, thymus and heart. Lyon, France: IARC Press, 2004:35–44.
15.
Vallières E, Shepherd FA, Crowley J, Van Houtte P, Postmus PE, Carney D, et al. International Association for the Study of Lung Cancer International Staging Committee and Participating Institutions. The IASLC Lung Cancer Staging Project: proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2009;4:1049–59.PubMedCrossRef
16.
Sonobe M, Manabe T, Wada H, Tanaka F. Mutations in the epidermal growth factor receptor gene are linked to smoking-independent, lung adenocarcinoma. Brit J Cancer. 2005;93:355–63.PubMedCentralPubMedCrossRef
17.
Antakli T, Schaefer RF, Rutherford JE, Read RC. Second primary lung cancer. Ann Thorac Surg. 1995;59:863–6.PubMedCrossRef
18.
Hoang T, Xu R, Schiller JH, Bonomi P, Johnson DH. Clinical model to predict survival in chemonaive patients with advanced non-small-cell lung cancer treated with third-generation chemotherapy regimens based on eastern cooperative oncology group data. J Clin Oncol. 2005;23:175–83.PubMedCrossRef
19.
Westeel V, Choma D, Clément F, Woronoff-Lemsi MC, Puqin JF, Dubiez A, et al. Relevance of an intensive postoperative follow-up after surgery for non-small cell lung cancer. Ann Thorac Surg. 2000;70:1185–90.PubMedCrossRef
20.
Hotta K, Sekine I, Suzuki K, Kondo H, Asamura H, Sumi M, et al. Distant failure after treatment of postoperative locoregional recurrence of non-small cell lung cancer. Thorac Cardiovasc Surg. 2003;51:283–7.PubMedCrossRef
21.
Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med. 2002;346:92–8.PubMedCrossRef
22.
American Society of Clinical Oncology: Clinical practice guidelines for the treatment of unresectable non-small-cell lung cancer. J Clin Oncol. 1997;15:2996–3018.
23.
Bunn PA Jr. Chemotherapy for advanced non-small-cell lung cancer: who, what, when, why? J Clin Oncol. 2002;20:23S–33S.PubMed
24.
Walsh GL, O’Connor M, Willis KM, Milas M, Wong RS, Nesbitt JC, et al. Is follow-up of lung cancer patients after resection medically indicated and cost-effective? Ann Thorac Surg. 1995;60:1563–70.PubMedCrossRef
25.
Sonobe M, Nakagawa M, Takenaka K, Katakura H, Adachi M, Yanagihara K, et al. Influence of epidermal growth factor receptor (EGFR) gene mutations on the expression of EGFR, phosphoryl-Akt, and phosphoryl-MAPK, and on the prognosis of patients with non-small cell lung cancer. J Surg Oncol. 2007;95:63–9.PubMedCrossRef
26.
Sonobe M, Kobayashi M, Ishikawa M, Kikuchi R, Nakayama E, Takahashi T, et al. Impact of KRAS and EGFR gene mutations on recurrence and survival in patients with surgically resected lung adenocarcinomas. Ann Surg Oncol. 2012;19:S347–54.PubMedCrossRef
27.
Burt M, Wronski M, Arbit E, Galicich JH. Resection of brain metastases from non-small-cell lung carcinoma. Results of therapy. Memorial Sloan-Kettering Cancer Center Thoracic Surgical Staff. J Thorac Cardiovasc Surg. 1992;103:399–410.PubMed
28.
Mehta M, Manon R. Are more aggressive therapies able to improve treatment of locally advanced non-small cell lung cancer: combined modality treatment? Semin Oncol. 2005;32:S25–34.PubMedCrossRef
29.
Sakamoto J, Sonobe M, Kobayashi M, Ishikawa M, Kikuchi R, Nakajima D, et al. Prognostic factors for patients in postoperative brain metastases from surgically resected non-small cell lung cancer. Int J Clin Oncol. 2014;19:50–6.PubMedCrossRef
30.
Porte H, Siat J, Guibert B, Lepimpec-Barthes F, Jancovici R, Bernard A, et al. Resection of adrenal metastases from non-small cell lung cancer: a multicenter study. Ann Thorac Surg. 2001;71:981–5.PubMedCrossRef
31.
Carey Sampson M, Katz A, Constine LS. Stereotactic body radiation therapy for extracranial oligometastases: does the sword have a double edge? Semin Radiat Oncol. 2006;16:67–76.PubMedCrossRef
32.
Bezjak A, Payne D. Radiotherapy in the management of non-small-cell lung cancer. World J Surg. 1993;17:741–50.PubMedCrossRef
33.
Aupérin A, Le Péchoux C, Rolland E, Curran WJ, Furuse K, Fournel P, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 2010;28:2181–90.PubMedCrossRef
Metadaten
Titel
Identification of Subsets of Patients with Favorable Prognosis After Recurrence in Completely Resected Non-Small Cell Lung Cancer
verfasst von
Makoto Sonobe, MD, PhD
Tetsu Yamada, MD, PhD
Masaaki Sato, MD, PhD
Toshi Menju, MD, PhD
Akihiro Aoyama, MD, PhD
Toshihiko Sato, MD, PhD
Fengshi Chen, MD, PhD
Mitsugu Omasa, MD, PhD
Toru Bando, MD, PhD
Hiroshi Date, MD, PhD
Publikationsdatum
01.08.2014
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 8/2014
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3630-9

Weitere Artikel der Ausgabe 8/2014

Annals of Surgical Oncology 8/2014 Zur Ausgabe

Endocrine Tumors

The Impact of Surgical Volume on Racial Disparity in Thyroid and Parathyroid Surgery

Healthcare Policy and Outcomes

Quality of Colorectal Cancer Care Among Veterans: A 10-Year Retrospective Cohort

Hepatobiliary Tumors

Hedgehog Signaling Between Cancer Cells and Hepatic Stellate Cells in Promoting Cholangiocarcinoma

Head and Neck Oncology

Minimal Clinically Important Differences in Quality of Life Scores of Oral Cavity and Oropharynx Cancer Patients

Bone and Soft Tissue Sarcomas

Radiation Therapy for Extremity Soft Tissue Sarcoma: In the Absence of a Clear Survival Benefit, Why Do We Give It?

Colorectal Cancer

What is the Effect of Laparoscopic Colectomy on Pattern of Colon Cancer Recurrence? A Propensity Score and Competing Risk Analysis Compared with Open Colectomy

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.