Respiratory investigation · 2025
The risk of recurrence in pathological stage II-IIIA non-small cell lung cancer without lymph node metastasis.
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Sumiya Ryusuke, Matsunaga Takeshi, Watanabe Yukio, Tomita Hisashi, Hayashi Takuo, Fukui Mariko, Hattori Aritoshi, Takamochi Kazuya, Suzuki Kenji
Аннотация
BACKGROUND: According to LACE analysis, patients diagnosed with p-Stage II-III non-small cell lung cancer (NSCLC) are usually indicated for adjuvant chemotherapy, including platinum doublets. We aimed to identify the risk of recurrence in NSCLC patients without lymph node metastasis.
METHODS: Between 2009 and 2018, 187 patients underwent lung resection of one or more lobes and mediastinal lymph node dissection for p-Stage II-IIIA NSCLC. Among them, 112 were included after excluding those with a history of lung cancer, perioperative chemotherapy. Staging was based on 8th Edition of IASLC staging system. Multivariate analysis was performed to identify important prognostic factors for oncologic outcomes.
RESULTS: Among the evaluated patients, 84 were male, and with a median age of 67 years. Seventy-one (51.4 %) patients were diagnosed with adenocarcinoma. The cancer stages were stage IIA in 34 patients, stage IIB in 57 patients, and stage IIIA in 21 patients. Multivariate analysis of disease-free survival revealed that vascular invasion (HR, 2.481; 95 %CI, 1.411-4.362, P < 0.01) and pathological T factor (HR, 1.819; 95 %CI, 1.226-2.699, P < 0.01) were the independent risk factors. Gray's test for equality of cumulative incidence functions revealed that the five-year cumulative incidence of recurrence was particularly high in patients with vascular invasion compared to that in patients without vascular invasion (21.5 % vs. 37.5 %, P = 0.03).
CONCLUSIONS: Vascular invasion is a significant predictor of lung cancer recurrence in patients with p-Stage II-IIIA NSCLC without lymph node metastasis. The patients without vascular invasion in this cohort had a favorable prognosis, with a 5-year recurrence rate of 21.5 %.
METHODS: Between 2009 and 2018, 187 patients underwent lung resection of one or more lobes and mediastinal lymph node dissection for p-Stage II-IIIA NSCLC. Among them, 112 were included after excluding those with a history of lung cancer, perioperative chemotherapy. Staging was based on 8th Edition of IASLC staging system. Multivariate analysis was performed to identify important prognostic factors for oncologic outcomes.
RESULTS: Among the evaluated patients, 84 were male, and with a median age of 67 years. Seventy-one (51.4 %) patients were diagnosed with adenocarcinoma. The cancer stages were stage IIA in 34 patients, stage IIB in 57 patients, and stage IIIA in 21 patients. Multivariate analysis of disease-free survival revealed that vascular invasion (HR, 2.481; 95 %CI, 1.411-4.362, P < 0.01) and pathological T factor (HR, 1.819; 95 %CI, 1.226-2.699, P < 0.01) were the independent risk factors. Gray's test for equality of cumulative incidence functions revealed that the five-year cumulative incidence of recurrence was particularly high in patients with vascular invasion compared to that in patients without vascular invasion (21.5 % vs. 37.5 %, P = 0.03).
CONCLUSIONS: Vascular invasion is a significant predictor of lung cancer recurrence in patients with p-Stage II-IIIA NSCLC without lymph node metastasis. The patients without vascular invasion in this cohort had a favorable prognosis, with a 5-year recurrence rate of 21.5 %.