Survival after recurrence following surgical resected non-small cell lung cancer: A multicenter, prospective cohort study

Takenaka, Tomoyoshi; Yano, Tokujiro; Yamazaki, Koji; Okamoto, Tatsuro; Hamatake, Motoharu; Shimokawa, Mototsugu; Mori, Masaki

doi:10.1016/j.xjon.2022.03.004

Cited by 12 publications

(7 citation statements)

References 30 publications

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“…The median PRS and 5-year PRS rates were 26 months and 24.5%, respectively, which were similar to those in previous reports [3][4][5][6] [4], and 2% [4], respectively, and those frequencies were comparable to present study. There are a limited number of reports analyzing prognosis according to initial recurrence sites.…”

Section: Discussionsupporting

confidence: 93%

“…Among patients with non-small cell lung cancer (NSCLC) who undergo surgery, 30-55% show recurrence [2,3]. The standard treatment for patients with NSCLC recurrence is similar to that for advanced-stage lung cancer, with a poor post-recurrence survival (PRS); median PRS of 17.6-30 months [3][4][5][6], and a 5-year PRS of 18.8-31.9% [3][4][5][6][7]. The local and distant recurrences have been reported in approximately 24-38% and 40-78% of cases, respectively [3,4,6].…”

Section: Introductionmentioning

confidence: 99%

“…Male sex, older age, smoking history, low-performance status, short-term recurrence, histological presence of symptoms, and poor differentiation have been reported to be poor prognostic factors for PRS [3][4][5][6]8]. However, there is still no consensus regarding the relationship between PRS and the site of recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative predictors for recurrence sites associated with poor post-recurrence survival after surgery of non-small cell lung cancer: a multicenter study

Isaka

Adachi

Murakami

et al. 2023

Preprint

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Background The recurrence site that influences post-recurrence survival (PRS) in patients with non-small cell lung cancer (NSCLC) undergoing surgery and the preoperative predictors of recurrence remain unclear. Methods Cohorts 1 and 2 had 4520 (who underwent complete resection for p-stage 0-IIIA NSCLC) and 727 (who experienced recurrence after surgery) patients, respectively. The initial sites of recurrence were the lungs (309 cases), thoracic lymph nodes (225 cases), pleura (112 cases), bone (110 cases), central nervous system (86 cases), abdomen (84 cases), cervical and axillary lymph nodes (38 cases), chest wall (13 cases), skin (5 cases), and eye and tongue (3 cases). For cohort 2 analysis, the initial recurrence site that resulted in poor PRS was analyzed by multivariable analysis using a Cox proportional hazard model. For cohort 1 analysis, the preoperative predictors of recurrence patterns with poor PRS were analyzed by multivariable analysis using a logistic regression model. Results In cohort 2 analysis, recurrence in the central nervous system (hazard ratio [HR], 1.59; p=0.003), bone (HR, 1.67; p<0.001), abdomen (HR, 1.79; p<0.001), and pleura (HR, 1.72; p<0.001) were independent poor prognostic recurrent sites for PRS and they were high-risk sites (HRS). Thoracic lymph nodes, cervical and axillary lymph nodes, lungs, chest wall, eye and tongue, and skin were low-risk sites (LRS) that did not affect PRS. Patients with multiple LRS without HRS recurrence had a worse prognosis than those with a single LRS without HRS recurrence (5-year PRS 19.5% vs. 37.0%, p=0.001) and were comparable to those with HRS recurrence (p=0.806). In cohort 1 analysis, preoperative predictors for HRS and multiple LRS recurrences were positron emission tomography (PET) maxSUV ≥ 3.0 (HR, 6.09; p<0.001), clinical stage ≥ II (HR, 2.36; p<0.001), and carcinoembryonic antigen (CEA) ≥ 5 ng/ml (HR, 1.46; p=0.001). The cumulative incidence rates of HRS and multiple LRS recurrences within 5 years were 46.7%, 26.6%, and 3.2% (p<0.001) in patients with 3, 1-2, and 0 of the above risks, respectively. Conclusions HRS and multiple LRS recurrences were vital recurrences associated with poor PRS. Preoperative PET maxSUV, CEA level, and clinical stage can predict the incidence of vital recurrence.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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Preoperative predictors for recurrence sites associated with poor post-recurrence survival after surgery of non-small cell lung cancer: a multicenter study

Isaka

Adachi

Murakami

et al. 2023

Preprint

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“…Curative lung resection offers the best chance of survival for patients with early‐stage non‐small lung cancer (NSCLC) 1 . However, approximately 30%–75% of NSCLC patients eventually experience local or metastatic recurrence after curative surgery and die from recurrent disease 2,3 . Platinum‐based adjuvant chemotherapy has been used as a standard adjuvant therapy since early 2000s, providing only a modest survival benefit 4 .…”

Section: Introductionmentioning

confidence: 99%

Genetic variants in key necroptosis regulators predict prognosis of non‐small cell lung cancer after surgical resection

et al. 2023

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BackgroundNecroptosis is a regulated inflammatory cell death which plays a significant role in cancer development and progression. In this study, we evaluated whether genetic variants in key regulators of necroptosis may affect survival outcome of non‐small cell lung cancer (NSCLC) patients after surgical resection.MethodsA total of 674 patients who underwent curative surgery were included. Fifteen genetic variants in key regulators of necroptosis (RIPK1, RIPK3, and MLKL) were selected. The association of these variants with survival outcomes was evaluated.ResultsTwo variants, RIPK1 rs17548629C > T and MLKL rs877375G > C, were associated with better overall survival and disease‐free survival in multivariate analyses. When the patients were divided according to histology, the associations were significant only in adenocarcinoma, but not in squamous cell carcinoma. RIPK1 rs17548629 C‐to‐T change was associated with significantly increased luciferase activity by modulating the binding of miR‐642a. Promoter assays showed a significantly increased promoter activity in MLKL rs877375C allele compared to G allele. Consistently, the mRNA expression level of RIPK1 and MLKL showed significant positive correlation with RIPK1 rs17548629C‐to‐T and MLKL rs877375G‐to‐C changes.ConclusionTwo genetic variants in key regulators in necroptosis, RIPK1 rs17548629C > T and MLKL rs877375G > C, may be used as biomarkers to predict survival outcomes in surgically resected NSCLC patients.

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“…In this issue of the Journal , the Kyushu Lung Surgery Study Group (KLSS) reported a prospective observational study from 14 institutions on lung cancer recurrence after radical resection and postrecurrence survival (PRS). 1 They analyzed 498 cases of lung cancer recurrence and reported that prognostic factors for PRS included performance status, age, presence of symptoms, interval between surgery and recurrence, number of recurrence foci, and epidermal growth factor receptor status. They concluded that the PRS differed significantly depending on the patient's background characteristics and the initial treatment of disease recurrence.…”

mentioning

confidence: 99%

Commentary: Postrecurrence survival in patients with lung cancer after curative surgery warrants systematic investigation to optimize management strategies

Yuen

Hsin

2022

JTCVS Open

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Survival after recurrence following surgical resected non-small cell lung cancer: A multicenter, prospective cohort study

Cited by 12 publications

References 30 publications

Preoperative predictors for recurrence sites associated with poor post-recurrence survival after surgery of non-small cell lung cancer: a multicenter study

Preoperative predictors for recurrence sites associated with poor post-recurrence survival after surgery of non-small cell lung cancer: a multicenter study

Genetic variants in key necroptosis regulators predict prognosis of non‐small cell lung cancer after surgical resection

Commentary: Postrecurrence survival in patients with lung cancer after curative surgery warrants systematic investigation to optimize management strategies

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