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Lymphovascular invasion, smoking history increase tumor recurrence in early-stage NSCLC
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MONTREAL — Lymphovascular invasion, central tumor location and smoking history increased the risk for recurrence in patients who underwent surgery to treat early-stage non–small cell lung cancer, according to data presented at CHEST Annual Meeting 2015.
“The goals of our research project was to identify the risks factors that increase tumor recurrence in early stage NSCLC, our patients are living longer and what is used to be a few years follow up has become a life-long journey,” Narjust Duma, MD, a resident physician at Rutgers New Jersey Medical School, told Healio.com/Pulmonology. “Our main question was, ‘when a new patient enters our clinic and archives remission, which patients would need a closer follow-up due to a higher risk [for] tumor recurrence?’”
Narjust Duma
Duma and colleagues reviewed the records of patients diagnosed with stage I and II non–small cell lung cancer (NSCLS) at Rutgers from 2000-2013.
The analysis included 673 patients —26% of whom developed local or distant recurrence, with a median time to recurrence of 18 months.
Eighty-seven percent of patients who developed local or distant recurrence underwent surgery with lobectomy as the most used procedure.
Patients with squamous cell carcinoma had a shorter median time to recurrence when compared with adenocarcinomas (13.2 months vs. 19.7 months; P < .02).
Lymphovascular invasion (HR = 4.3; 95% CI, 3.32-5), high histologic grade (HR = 2.76; 95% CI, 1.34-5.97), as well as previous smoking history (HR = 1.98; 95% CI, 1.62-2.82) predicted recurrence.
“Patients with lymphovascular invasion have the highest recurrence risk followed by high histologic grade tumors with the former having a direct correlation with distant metastasis,” she said.
It may be beneficial for physicians to instill close surveillance in patients after surgical resection, Duma told Healio.com/Pulmonology
“We also conclude that recurrence following treatment of early-stage NSCLC can be considered a multifactorial process dependent on clinicophatological, biological and treatment characteristics and patients with these risk factors may benefit from close surveillance after surgical resection, adjuvant therapy and aggressive management of local recurrence.” – by Ryan McDonald
Reference:
Duma N, et al. Abstract 204342. Presented at: CHEST Annual Meeting 2015; Oct. 24-28, 2015; Montreal.
Disclosure: The researchers report no relevant financial disclosures.