Evaluation of factors relating to tumor recurrence and survival after resection of lung cancer.

摘要

BACKGROUND: Most patients whose lung cancers are resected have a local or distant recurrence, as determined postoperatively, or show residual or local disease at the time of autopsy. There are few reports that have described a relationship between tumor recurrence and variable factors such as stage, pathology, surgical method, and mode of recurrence. PURPOSE: To determine factors associated with tumor recurrence after resection of lung cancer. MATERIAL AND METHODS: A total of 124 patients who underwent surgical resection of lung cancer also underwent follow-up with computed tomography (CT) imaging (6, 12, and 24 months after surgery) for the surveillance of tumor recurrence. The CT images were retrospectively reviewed, focusing on the hilar or mediastinal lymph nodes, surgical margin, lung parenchyma, pleura, chest wall, and the presence of distant metastasis. The rate, mode, and time to recurrence after surgery were compared with the tumor stage, pathology, and operative method to identify factors associated with tumor recurrence. The correlation between survival and tumor stage was also evaluated. Results: For 112 cases, a tumor recurred in 52 (41.0%) cases. The recurrence rate was lower for patients with stage IA (n=5, 9.6%) as compared to patients with stage IB (n=18, 34.6%), stage II (n=11, 21.1%), or stage IIIA (n=18, 34.6%). The differences in the recurrence rate between patients with stage IA and stage IB, stage IA and stage II, and stage IA and stage IIIA were statistically significant (P<0.05). The mode of recurrence in the 52 cases was local recurrence (n=31, 59.6%), distant metastasis (n=17, 32.7%), and combined lesions (n=4, 7.7%). The variations in survival rate were statistically significant between patients with stage IA and stage IB (P<0.05) and between patients with stage IA and stage IIIA (P<0.01). Other factors such as pathology and operative method did not correlate with tumor recurrence or patient survival. CONCLUSION: The tumor stage was the only factor associated with tumor recurrence and survival after resection of lung cancer.