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OA01 - Risk Assessment and Follow up in Surgical Patients (ID 371)
- Event: WCLC 2016
- Type: Oral Session
- Track: Surgery
- Presentations: 1
OA01.07 - Alternative Follow-Up Methods Based on Recurrence Patterns after Surgery for Non-Small Cell Lung Cancer (ID 4323)
11:00 - 12:30 | Author(s): T. Nagashima
There is no consensus for the appropriate follow-up of patients after complete resection of non-small cell lung cancer (NSCLC). Our study was designed to visually represent postoperative recurrence patterns for NSCLC with the use of event dynamics and to optimize postoperative follow-up schedule based on risk factors for recurrence.
A total of 829 patients with NSCLC who underwent complete pulmonary resection were studied. There were 538 men and 291 women with a mean age of 69.2 at the time of operation. The majority of the patients had adenocarcinoma (62.5%), underwent lobectomy (85.9%) and pathological stage IA (47.3%). Event dynamics, based on the hazard rate, were evaluated and only first events (distant metastases or local recurrence) were considered. The effects of sex, histological type and pathological stage were studied.
On non-parametric kernel smoothing, the resulting hazard rate curves indicated that the recurrence risk pattern was definitely correlated to sex, with a sharp peak in the first year for men and broad peak during the 2 to 3 years for women. This finding was also confirmed by the analysis of histological type. Although pathological stage IA patients lacked such a large peak in both sexes during the follow-up period, gender difference was shown in pathological stage IB and stage IIA to IIIB patients. Figure 1
The use of recurrence dynamics allows the times of peak recurrence to be visualized. The hazard rate and the peak times of recurrence differed considerably between genders in pathological stage IB or higher. Postoperative follow-up methods should be based on currently recommended follow-up guidelines, give adequate consideration to the recurrence patterns, and be modified individually.
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