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Long-term outcomes of 5-year survivors without recurrence after the complete resection of non-small cell lung cancer after lobectomy: a landmark analysis in consideration of competing risks

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Abstract

Purpose

Among non-small cell lung cancers (NSCLC), 5 years is a benchmark in cancer control and treatment, but a certain percentage of cases recur after 5 years. The long-term post-recurrence outcomes remain controversial. To examine the accurate prognostic factors associated with survival and cancer recurrence among 5-year survivors, a landmark analysis that considered competing risks was performed.

Methods

Complete resection of NSCLC was performed in 2482 patients between January 2003 and December 2015. A total of 1431 patients were 5-year survivors without recurrence. A landmark time analysis was applied to the overall survival (OS) and recurrence-free survival (RFS) from 5 years after surgery, and the findings were calculated using the Kaplan–Meier method. The cumulative incidence of cause-specific death and recurrence was estimated using the cumulative incidence function, while carefully considering the competing risks.

Results

Postoperative recurrence was detected in 732 patients, of whom 68 (9.3%) had recurrence after 5 years. The median follow-up period was 8.2 years. In the competing risk analysis, the independent poor prognostic factors associated with cause-specific death were age ≥ 75 years, lymph node metastasis and pleural invasion.

Conclusions

Patients requiring a follow-up for > 5 years were aged ≥ 75 years and had either lymph node metastasis or pleural invasion.

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Acknowledgements

A native speaker of English has professionally proofread this manuscript.

This paper was presented at EACTS in Madrid, Spain in October 2021.

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Authors and Affiliations

  1. Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Yutaro Koike, Keiju Aokage, Ken Onodera, Joji Samejima, Tomohiro Miyoshi, Kenta Tane & Masahiro Tsuboi

  2. Biostatistics Division, Center for Research Administration and Support, National Cancer Center Hospital East, Chiba, Japan

    Masashi Wakabayashi

  3. Clinical Research Support Office, National Cancer Center Hospital East, Chiba, Japan

    Takashi Ikeno

  4. Department of Thoracic Surgery, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo City, Tokyo, 113-0033, Japan

    Yutaro Koike & Kenji Suzuki

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  1. Yutaro Koike
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Correspondence to Keiju Aokage.

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Koike, Y., Aokage, K., Wakabayashi, M. et al. Long-term outcomes of 5-year survivors without recurrence after the complete resection of non-small cell lung cancer after lobectomy: a landmark analysis in consideration of competing risks. Surg Today (2024). https://doi.org/10.1007/s00595-024-02804-2

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