Distant Failure Patterns of Resected Stage Ⅰ Non-small Cell Lung Cancer: A Long-term Follow-up

第一期非小細胞型肺癌病人術後發生遠端轉移之型態：長期追蹤分析

洪榮志(Jung-Jyh Hung) ； 吳玉琮(Yu-Chung Wu) ； 黃敏雄(Min-Hsiung Huang) ； 黃炳勳(Biing-Shiung Huang) ； 王良順(Liang-Shun Wang) ； 許文虎(Wen-Hu Hsu)

《Formosan Journal of Surgery》 39卷5期 (2006/10) Pp. 227-235

https://doi.org/10.29833/FJS.200610.0001

摘要

Objective: Resection is the best treatment for patients with Stage I non-small cell lung cancer (NSCLC). Distant metastasis is the most frequent cause of treatment failure and cause of death in NSCLC. The goal of this study was to evaluate the clinicopathologic characteristics, pattern of distant failure, disease-free time and survival in patients with resected Stage I NSCLC.
Methods: We retrospectively reviewed the clinicopathologic characteristics of 155 patients of resected Stage I NSCLC with distant failure in Taipei Veterans General Hospital between 1980 and 2000. Disease-free time, survival, and their predictors were analyzed.
Results: Patients were followed up for 20.5 months (mean, 25.4 19.5 months). Distant failure occurred at 11.5 months (median, 95% CI: 9.8 to 13.6 months). The disease-free rate and survival at 2 and 5 years were 12.9% and 1.3%, and, 43.2% and 6.5%, respectively. The sites of distant failure were bone in 52 (33.5%), lung to lung in 39 (25.2%), brain in 37 (23.9%) and liver in 17 (11.0%). A second site of distant failure was noted in 35 of 155 patients (22.6%): bone in 13 (37.1%) and lung to lung in 8 (22.9%). Multivariate analysis showed that tumor size and histological type had significant impact on disease-free survival (P=0.003, 0.003), and tumor size, histological type and first site of distant failure had significant impact on overall survival (P=0.034, ＜0.001, 0.009). Patients with squamous cell carcinoma survived shorter than patients with adenocarcinoma (hazard ratio 1.90, 95% CI: 1.29~2.79). Patients with the first distant failure site being brain and bone had significantly worse survival than those with lung to lung distant failure (hazard ratio: 2.04 and 1.80, 95% CI: 1.25-3.35, and 1.16-2.77).
Conclusions: The survival was poor for patients of resected Stage I non-small cell lung cancer after distant failure. Tumor size is the significant predictor for both disease-free and overall survival.

並列摘要

Objective: Resection is the best treatment for patients with Stage I non-small cell lung cancer (NSCLC). Distant metastasis is the most frequent cause of treatment failure and cause of death in NSCLC. The goal of this study was to evaluate the clinicopathologic characteristics, pattern of distant failure, disease-free time and survival in patients with resected Stage I NSCLC.
Methods: We retrospectively reviewed the clinicopathologic characteristics of 155 patients of resected Stage I NSCLC with distant failure in Taipei Veterans General Hospital between 1980 and 2000. Disease-free time, survival, and their predictors were analyzed.
Results: Patients were followed up for 20.5 months (mean, 25.4 19.5 months). Distant failure occurred at 11.5 months (median, 95% CI: 9.8 to 13.6 months). The disease-free rate and survival at 2 and 5 years were 12.9% and 1.3%, and, 43.2% and 6.5%, respectively. The sites of distant failure were bone in 52 (33.5%), lung to lung in 39 (25.2%), brain in 37 (23.9%) and liver in 17 (11.0%). A second site of distant failure was noted in 35 of 155 patients (22.6%): bone in 13 (37.1%) and lung to lung in 8 (22.9%). Multivariate analysis showed that tumor size and histological type had significant impact on disease-free survival (P=0.003, 0.003), and tumor size, histological type and first site of distant failure had significant impact on overall survival (P=0.034, ＜0.001, 0.009). Patients with squamous cell carcinoma survived shorter than patients with adenocarcinoma (hazard ratio 1.90, 95% CI: 1.29~2.79). Patients with the first distant failure site being brain and bone had significantly worse survival than those with lung to lung distant failure (hazard ratio: 2.04 and 1.80, 95% CI: 1.25-3.35, and 1.16-2.77).
Conclusions: The survival was poor for patients of resected Stage I non-small cell lung cancer after distant failure. Tumor size is the significant predictor for both disease-free and overall survival.

並列關鍵字

Stage Ⅰ non-small cell lung cancer ； distant failure ； predictor ； survival