+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Local recurrence after surgery for early stage lung cancer: an 11-year experience with 975 patients

, : Local recurrence after surgery for early stage lung cancer: an 11-year experience with 975 patients. Cancer 115(22): 5218-5227

The objective of the current study was to evaluate the actuarial risk of local failure (LF) after surgery for stage I to II nonsmall cell lung cancer (NSCLC) and assess surgical and pathologic factors affecting this risk. The records, including pertinent radiologic studies, of all patients who underwent surgery for T1 to T2, N0 to N1 NSCLC at Duke University between 1995 and 2005 were reviewed. Risks of disease recurrence were estimated using the Kaplan-Meier method. A multivariate Cox regression analysis assessed factors associated with LF in the entire cohort and a subgroup undergoing optimal surgery for stage IB to II disease. For all 975 consecutive patients, the 5-year actuarial risk of local and/or distant disease recurrence was 36%. First sites of failure were local only (25%), local and distant (29%), and distant only (46%). The 5-year actuarial risk of LF was 23%. On multivariate analysis, squamous/large cell histology (hazards ratio [HR], 1.98), stage > IA (HR, 2.02), and sublobar resections (HR, 1.99) were found to be independently associated with a higher risk of LF. For the subset of patients (n = 445) undergoing at least a lobectomy with negative surgical margins and currently considered for adjuvant chemotherapy (stage IB-II disease), the 5-year actuarial risk of LF was 27%. Within this subgroup, squamous/large cell histology (HR, 2.5) and lymphovascular space invasion (HR, 1.74) were associated with a higher risk of LF. The 5-year rate of LF was 13%, 32%, and 47%, respectively, with 0, 1, or 2 risk factors. Greater than half of disease recurrences after surgery for early stage NSCLC involved local sites. Pathologic factors may help to distinguish those patients at highest risk.


PMID: 19672942

DOI: 10.1002/cncr.24625

Other references

Saito, K.; Sato, H.; Kanayama, A., 1985: Studies on the ecology of blackflies diptera simuliidae 7. fauna of blackflies in saitama prefecture japan. The fauna and distributions of the blackflies in Saitama Prefecture were investigated by collecting the early stages flies from the streams. The survey was conducted at 41 sites in November-December of 1983 and in January of 1985. The blackflies,...

Meyerhoff, W.L.; Giebink, G.S.; Shea, D.A.; Le, C.T., 1982: Effect of tympanostomy tubes on the pathogenesis of acute otitis media. Intubation of the tympanic membrane as a treatment for acute otitis media is extremely controversial. This study was designed to determine the effect of tympanic membrane intubation in an experimental model for acute purulent otitis media. The rig...

Anonymous, 2011: Deletion of the metabolic transcriptional coactivator PGC1beta induces cardiac arrhythmia. Peroxisome proliferator-activated receptor- coactivators PGC1α and PGC1β modulate mitochondrial biogenesis and energy homeostasis. The function of these transcriptional coactivators is impaired in obesity, insulin resistance, and type 2...

Bazilevich, N.I., 1950: Types of chemical affinity of the natural salt accumulations of the Barabinsk lowland.. These salt accumulations are of the soda type and are classified according to their (Cl + SO4): HCO3 ratio.

Barros, S.; de Carvalho, J., 2012: Pathological gambling and primary antiphospholipid (Hughes) syndrome: a unique neuropsychiatric association. Neuropsychiatric conditions are common in patients with primary antiphospholipid syndrome (APS) with or without vascular thrombosis of the central nervous system. There are frequent descriptions of memory alterations, cognition and mood disorders,...

Fradkin, G.E.; Torosian, M.V.; Shishkova, O.V.; Aĭzenberg, O.A.; Rabinkova, E., 1980: Relation between Escherichia coli K-12 viability and mutability and the balance between DNA and protein synthesis. IV. Relation between disruptions in the balance between DNA and protein synthesis and the mutability and viability of cells exposed to ultraviolet and gamma radiation or treated with N-methyl-N-nitroso-N'-nitrosoguanidine. It has been established that the restoring of the disturbed DNA and protein syntheses balance in cells exposed to UV- and gamma-irradiation or nitrosoguanidine treatment, brought about by the inhibition of the protein synthesis, differently affect...

Bessho, C., 1985: Verbs in our life: hide and appear. Japanese Journal of Nursing 37(11): 69-73

Richards, V., 1877: A Sporadic Outbreak of Cholera. Indian Medical Gazette 12(5): 124-124

Jones, E., 1987: Translation of quantitative measures for use in cross-cultural research. Nursing Research 36(5): 324-327

Bethcke, B., 1987: Can fetuses feel pain? Pain perception in fetuses and newborn infants is not measurable--nonetheless operate only with anesthesia--controversial methods. Fortschritte der Medizin 105(35): 78-79