Prognostic factors in post-surgical recurrence of lung cancer

Abstract

Background. The choice of treatment modalities for the post-surgical recurrence of lung cancer is still controversial despite the frequency of its occurrence. Because there are various recurrence and progression patterns in recurrent lung cancer, it is important to clarify those factors which have prognostic significance. These prognostic factors would be helpful for clinicians' decision-making in terms of treatment directions.

Methods. To explore treatment directions for the post-surgical recurrence of lung cancer, we analyzed findings in 123 patients who died of recurrence, and identified factors of prognostic importance by univariate and multivariate analyses.

Results. The median survival time (MST) and 1-year, 2-year, and 3-year survival rates of the 123 patients were 218 days and 30.8%, 13.8% and 3.3%, respectively. The survival time according to the first relapse site was examined, and lung was most favorable (MST, 353 days). Liver and bone were unfavorable (MST, 188 and 166 days, respectively). On univariate analysis, patients with a relapse-free period of 1 year or more after surgery survived for significantly longer than patients who developed recurrence less than 1 year after surgery (MST, 286 days vs 190 days, respectively; P < 0.01). On multivariate analysis, the relapse-free period proved to be the most important prognostic factor.

Conclusion. We suggest that patients who develop recurrence 1 year or more after surgery may be better off being followed-up with supportive measures, rather than with chemotherapy, because they have a relatively favorable prognosis.