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Clinical outcome of patients with recurrent non-small cell lung cancer after trimodality therapy

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Abstract

Purposes

The purpose of this study was to review the clinical course of patients with recurrence after induction chemoradiotherapy followed by surgery (trimodality therapy) for locally advanced non-small cell lung cancer (LA-NSCLC) and to identify the factors associated with favorable clinical outcome after recurrence.

Methods

We analyzed the records of 140 patients with LA-NSCLC who were treated with trimodality therapy between 1999 and 2014.

Results

Recurrence developed after trimodality therapy in 48 patients. A yp-N positive status was associated with a high risk of recurrence (HR, 2.05; P = 0.048). Of the 45 of these patients able to be assessed retrospectively, 18 had oligometastatic recurrence and 20 underwent local treatment with curative intent. Local treatment was most frequently given to patients with oligometastatic recurrence (P < 0.001). The median post-recurrence survival (PRS) was 41.4 months, and the 2-year PRS rate was 62%. Patients who received local treatment showed better PRS (P = 0.009). The presence of liver metastasis (P = 0.008), bone metastasis (P = 0.041), or dissemination (P < 0.0001) were associated with worse PRS.

Conclusion

The survival of patients who received aggressive local treatment for postoperative recurrence after trimodality therapy for LA-NSCLC was better than that of patients who did not.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikatacho, Kita-ku, Okayama, 700-8558, Japan

    Ken Suzawa, Junichi Soh, Yuta Takahashi, Hiroki Sato, Kazuhiko Shien, Hiromasa Yamamoto, Shinichiro Miyoshi & Shinichi Toyooka

  2. Department of Radiology, Okayama University Hospital, Okayama, Japan

    Susumu Kanazawa

  3. Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan

    Katsuyuki Kiura

Authors
  1. Ken Suzawa
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  2. Junichi Soh
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  3. Yuta Takahashi
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  4. Hiroki Sato
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  5. Kazuhiko Shien
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  6. Hiromasa Yamamoto
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  7. Susumu Kanazawa
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  8. Katsuyuki Kiura
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  9. Shinichiro Miyoshi
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  10. Shinichi Toyooka
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Corresponding author

Correspondence to Shinichi Toyooka.

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Conflict of interest

S. Toyooka had honorarium and grants and endowments from Taiho Pharmaceutical Co., Ltd. K. Kiura had honorarium, grants and endowments from Taiho Pharmaceutical Co., Ltd., Nippon Kayaku Co., Ltd., Ono Pharmaceutical Co., Ltd, and Nippon Boehringer Ingelheim Co., Ltd. No other authors have any conflicts of interest to declare.

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Suzawa, K., Soh, J., Takahashi, Y. et al. Clinical outcome of patients with recurrent non-small cell lung cancer after trimodality therapy. Surg Today 49, 601–609 (2019). https://doi.org/10.1007/s00595-019-1774-8

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  • DOI: https://doi.org/10.1007/s00595-019-1774-8

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