Tumor recurrence after complete resection for non-small cell lung cancer

Matthew D. Taylor, Alykhan S. Nagji, Castigliano Bhamidipati, Nicholas Theodosakis, Benjamin D. Kozower, Christine L. Lau, David R. Jones

Research output: Contribution to journalArticle

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Abstract

Background: Long-term survival after R0 resection for non-small cell lung cancer (NSCLC) is less than 50%. The majority of mortality after resection is related to tumor recurrence. The purpose of this study was to identify independent perioperative and pathologic variables that are associated with NSCLC recurrence after complete surgical resection. Methods: A retrospective examination was performed of a prospectively maintained database of patients who underwent resection for NSCLC from July 1999 to August 2008 at a single institution. Clinicopathologic variables were evaluated for their influence on time to recurrence. Cox's proportional regression hazard model examined the association of recurrence in NSCLC. Results: A total of 1,143 patients met inclusion criteria and had complete follow-up information. Of these patients, 378 (33.1%) had recurrence of the primary cancer. Median follow-up was 24 months (range, 3-134 months). Preoperative tumor maximum standardized uptake value (SUV max) greater than 5 was associated with increased risk of recurrence (hazard ratio [HR], 1.81; p = 0.01). Preoperative radiation was independently associated with recurrence (HR, 1.98; p = 0.05) as well as the presence of pathologic stage II and stage III disease (stage II: HR, 2.53; p = 0.05; stage III: HR, 6.49; p = 0.006). Subgroup analysis found that sublobar resection was also associated with locoregional recurrence after resection (HR, 4.17; p = 0.02) and lymphovascular invasion of distant recurrence (HR, 4.21; p = 0.002). Conclusions: In the largest series reported to date on postresectional recurrence of NSCLC, SUV max greater than 5, increasing pathologic stage, and the administration of preoperative radiation were independently associated with NSCLC recurrence after resection. Sublobar resection was independently associated with locoregional recurrence, and lymphovascular invasion was associated with distant recurrence.

Original languageEnglish (US)
Pages (from-to)1813-1821
Number of pages9
JournalAnnals of Thoracic Surgery
Volume93
Issue number6
DOIs
StatePublished - Jun 1 2012
Externally publishedYes

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Non-Small Cell Lung Carcinoma
Recurrence
Neoplasms
Radiation
Proportional Hazards Models
Databases

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Taylor, M. D., Nagji, A. S., Bhamidipati, C., Theodosakis, N., Kozower, B. D., Lau, C. L., & Jones, D. R. (2012). Tumor recurrence after complete resection for non-small cell lung cancer. Annals of Thoracic Surgery, 93(6), 1813-1821. https://doi.org/10.1016/j.athoracsur.2012.03.031

Tumor recurrence after complete resection for non-small cell lung cancer. / Taylor, Matthew D.; Nagji, Alykhan S.; Bhamidipati, Castigliano; Theodosakis, Nicholas; Kozower, Benjamin D.; Lau, Christine L.; Jones, David R.

In: Annals of Thoracic Surgery, Vol. 93, No. 6, 01.06.2012, p. 1813-1821.

Research output: Contribution to journalArticle

Taylor, MD, Nagji, AS, Bhamidipati, C, Theodosakis, N, Kozower, BD, Lau, CL & Jones, DR 2012, 'Tumor recurrence after complete resection for non-small cell lung cancer', Annals of Thoracic Surgery, vol. 93, no. 6, pp. 1813-1821. https://doi.org/10.1016/j.athoracsur.2012.03.031
Taylor, Matthew D. ; Nagji, Alykhan S. ; Bhamidipati, Castigliano ; Theodosakis, Nicholas ; Kozower, Benjamin D. ; Lau, Christine L. ; Jones, David R. / Tumor recurrence after complete resection for non-small cell lung cancer. In: Annals of Thoracic Surgery. 2012 ; Vol. 93, No. 6. pp. 1813-1821.
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abstract = "Background: Long-term survival after R0 resection for non-small cell lung cancer (NSCLC) is less than 50{\%}. The majority of mortality after resection is related to tumor recurrence. The purpose of this study was to identify independent perioperative and pathologic variables that are associated with NSCLC recurrence after complete surgical resection. Methods: A retrospective examination was performed of a prospectively maintained database of patients who underwent resection for NSCLC from July 1999 to August 2008 at a single institution. Clinicopathologic variables were evaluated for their influence on time to recurrence. Cox's proportional regression hazard model examined the association of recurrence in NSCLC. Results: A total of 1,143 patients met inclusion criteria and had complete follow-up information. Of these patients, 378 (33.1{\%}) had recurrence of the primary cancer. Median follow-up was 24 months (range, 3-134 months). Preoperative tumor maximum standardized uptake value (SUV max) greater than 5 was associated with increased risk of recurrence (hazard ratio [HR], 1.81; p = 0.01). Preoperative radiation was independently associated with recurrence (HR, 1.98; p = 0.05) as well as the presence of pathologic stage II and stage III disease (stage II: HR, 2.53; p = 0.05; stage III: HR, 6.49; p = 0.006). Subgroup analysis found that sublobar resection was also associated with locoregional recurrence after resection (HR, 4.17; p = 0.02) and lymphovascular invasion of distant recurrence (HR, 4.21; p = 0.002). Conclusions: In the largest series reported to date on postresectional recurrence of NSCLC, SUV max greater than 5, increasing pathologic stage, and the administration of preoperative radiation were independently associated with NSCLC recurrence after resection. Sublobar resection was independently associated with locoregional recurrence, and lymphovascular invasion was associated with distant recurrence.",
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AU - Lau, Christine L.

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