Original articleGeneral thoracicDifferences in Patterns of Recurrence in Early-Stage Versus Locally Advanced Non-Small Cell Lung Cancer
Section snippets
Patients and Methods
A retrospective review of a prospectively maintained database was performed. Patients who underwent complete surgical resection for stage IIIA NSCLC from January 2004 to December 2009 and who had evaluable data on recurrence status were included in the study. Staging was based on the seventh edition of the American Joint Committee on Cancer staging system [9]. Baseline patient characteristics and treatments were obtained from the database. Inasmuch as some patients had undergone neoadjuvant
Results
For the analysis of stage IIIA patients, a total of 346 patients received follow-up care for a median of 35 months (range, 3 to 92 months). Baseline characteristics are summarized in Table 1. More than half of the patients (195, 56%) underwent neoadjuvant therapy, most commonly chemotherapy alone. Approximately half of these patients (101, 51%) had final pathologic stage IIIA disease, whereas the remaining patients were downstaged. Less than half of all patients (151, 44%) had pathologic stage
Comment
Marked differences were found in the postresection patterns of recurrence between patients with locally advanced NSCLC and those with early-stage disease. The rate of recurrence was considerably higher for the stage IIIA cohort, peaking during the first 2 years; it was sustained, however, throughout the first 4 years for both cohorts. More than half of the stage IIIA patients experienced recurrences, the vast majority of which were distant metastases, most commonly in the brain. By comparison,
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