Time-Varying Pattern of Postoperative Recurrence Risk of Early-Stage T1a-T2bN0M0 Non-Small Cell Lung Cancer NSCLC: Results of a Single-Center Study of 994 Chinese PatientsReportar como inadecuado




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Background

The aim of this study was to analyze the time-varying pattern of recurrence risk of early-stage T1a-T2bN0M0 non-small cell lung cancer NSCLC after surgery using the hazard function and identify patients who might benefit from adjuvant chemotherapy.

Patients and Methods

This retrospective study enrolled 994 patients with early-stage NSCLC who underwent radical surgical resection between January 1999 and October 2009. Survival curves were generated using the Kaplan-Meier method, and the annual recurrence hazard was estimated using the hazard function.

Results

The median recurrence-free survival RFS was 8.8 years. The life table survival analysis showed that the 1-year, 3-year, 5-year and 10-year recurrence rates were 82.0%, 67.0%, 59.0% and 48.0%, respectively. Approximately 256 25.7% patients experienced relapse locoregional: 32 3.2% and distant: 224 22.5%, and 162 patients died from cancer. The annual recurrence hazard curve for the entire population showed that the first major recurrence surge reached a maximum 1.6 years after surgery. The curve subsequently declined until reaching a nadir at 7.2 years. A second peak occurred at 8.8 years. An analysis of clinical-pathological factors demonstrated that this double-peaked pattern was present in several subgroups.

Conclusions

The presence of a double-peaked pattern indicates that there is a predictable temporal distribution of the recurrence hazard of early-stage NSCLC. The annual recurrence hazard may be an effective method of selecting patients at high risk of recurrence, who may benefit from adjuvant therapy.



Autor: Jian-fei Zhu , Xing-yu Feng , Xue-wen Zhang, Ying-sheng Wen, Peng Lin, Tie-hua Rong, Ling Cai , Lan-jun Zhang

Fuente: http://plos.srce.hr/



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