Time-Varying Pattern of Postoperative Recurrence Risk of Early-Stage (T1a-T2bN0M0) Non-Small Cell Lung Cancer (NSCLC): Results of a Single-Center Study of 994 Chinese Patients

Jing-ci, Zhu; Feng, Xing; Zhang, Xuewen; Wen, Ying Sheng; Lin, Peng; Rong, Tie Hua; Cai, Ling; Zhang, Lan Jun

doi:10.1371/journal.pone.0106668

Cited by 18 publications

(15 citation statements)

References 48 publications

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“…The peak of cancer mortality in PTC occurs later and is smaller compared to that in breast cancer. The hazard of recurrence also reaches its first and second peak significantly later compared to breast cancer, early-stage NSCLC, or gastric cancer (8)(9)(10). The origin of the multiple-peak hazard curves has not yet been established, although Demicheli et al proposed the tumor dormancy hypothesis where the growth of micrometastatic or residual foci in various biological steady states could occur differently and suddenly, rather than uniformly, and may be continuously triggered by several biological mechanisms (42,43).…”

Section: Hazards Of Failuresmentioning

confidence: 99%

Time-Varying Pattern of Mortality and Recurrence from Papillary Thyroid Cancer: Lessons from a Long-Term Follow-Up

Dong

Horiuchi

Tokumitsu

et al. 2019

Thyroid

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Background: Little is known about annual hazard rates of cancer mortality and recurrence for papillary thyroid cancer (PTC). This study investigated the time-varying pattern of cancer death and recurrence from PTC and independent prognostic factors for cause-specific mortality (CSM) and recurrence of PTC. Methods: This retrospective chart review enrolled 466 patients diagnosed with PTC who underwent curative initial surgery between April 1981 and December 1991 with a median follow-up of 18.4 years. Clinical characteristics, cancer mortality (primary endpoint), and recurrence (secondary endpoint) were ascertained. The failure rates of either death or recurrence were estimated using the Kaplan-Meier methods, and annual death/recurrence hazard was depicted using hazard function. Results: In this Japanese cohort where only 1.5% of patients received radioactive iodine therapy, the 10-, 20-, and 30-year CSM rates were 2.7%, 6.2%, and 8.6%, respectively. Eleven (44.0%) cases of death occurred within the first 10 years, whereas 10 (40.0%) and 4 (16.0%) cases occurred within 10-20 and 20-30 years after surgery, respectively. The 10-, 20-, and 30-year recurrence rates were 11.3%, 21.8%, and 29.4%, respectively. Forty-six (54.8%) cases of recurrence occurred within the first 10 years, predominantly within the first five years (31 cases; 36.9%), whereas 29 (34.5%), 7 (8.3%), and 2 (2.4%) cases occurred within 10-20, 20-30, and ‡30 years after surgery, respectively. Age ‡55 years was the only independent prognostic factor for CSM. Age ‡55 years, male, tumor size > 4 cm, extranodal extension, and positive pathological lymph node metastasis were independent prognostic factors for recurrence. The annual hazard curve of cancer mortality presented a double-peaked distribution, with a first peak at the 10th year, and the second peak reaching the maximum at the 20th year after surgery for the entire population. The annual hazard curve of recurrence showed a triple-peaked pattern, with surges at about 12, 22, and 29 years after surgery. Conclusions: Patients with PTC harboring at least one of the prognostic characteristics may be at persistent risk of cancer mortality and recurrence even 10 or more years after initial treatment. Understanding the hazard rate of PTC is key to creating more tailored treatment and surveillance.

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Section: Hazards Of Failuresmentioning

confidence: 99%

Time-Varying Pattern of Mortality and Recurrence from Papillary Thyroid Cancer: Lessons from a Long-Term Follow-Up

Dong

Horiuchi

Tokumitsu

et al. 2019

Thyroid

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“…However, 20-30% of early stage NSCLC patients undergo a relapse even upon complete surgical resection of their tumor (32,33). Platinum-based adjuvant chemotherapy for NSCLC patients with stage IB-IIIA disease has been investigated in several clinical trials (34)(35)(36)(37).…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of ABCB1 in stage I lung adenocarcinoma

et al. 2017

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Abstract. Cancer stem cell (CSC) properties have been recently proposed to explain tumor carcinogenesis and multidrug resistance in several human cancers, including non-small cell lung cancer (NSCLC). The present study examined the protein expression of three CSC-associated markers, namely ATP binding cassette subfamily B member 1 (ABCB1), aldehyde dehydrogenase 1 family member A1 (ALDH1A1) and cluster of differentiation (CD) 44, by immunohistochemistry in 194 NSCLC patients who underwent complete resection of NSCLC tumors. The association between the expression of these proteins and patient prognosis was evaluated to clarify the prognostic significance of CSC-associated markers in NSCLC patients. Positive staining for ABCB1 demonstrated a trend toward worse survival compared with negative staining in stage I-III NSCLC. Negative staining for ALDH1 or CD44 exhibited a trend toward worse survival compared with positive staining in stage I-III NSCLC. It was observed that patients with stage I lung adenocarcinoma (ADC) showing positivity for ABCB1 expression had significantly poorer survival than those with negative ABCB1 staining (P=0.03). Furthermore, stage I ADC patients with wild-type epidermal growth factor receptor (EGFR) who exhibited positive staining for ABCB1 had significantly shorter disease-free survival (DFS) compared with patients with negative staining for ABCB1 (P<0.01). Analyses by univariate and multivariate Cox proportional hazards models revealed that ABCB1-positive staining was significantly associated with DFS and was an independent prognostic factor (hazard ratio, 3.49; P<0.05) in these patients. These results suggest that ABCB1 protein expression is useful for predicting prognosis and selecting patients for post-operative therapy in stage I lung ADC patients, particularly those harboring wild-type EGFR.

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“…However, in early-stage NSCLC (T1a-T2bN0M0) when diagnosed using TNM staging, the recurrence rates are still high, even after curative surgery. 62 Thus, certain limitations exist in traditional TNM staging: this system fails to evaluate tumor staging accurately. Veronique Hofman et al evaluated the presence of CTCs in patients with NSCLC undergoing surgery by ISET and discovered that the presence of CTCs in resectable patients with NSCLC was independent of TNM stage and was associated with worse prognosis.…”

Section: Identifying Ctcs For Early Diagnosismentioning

confidence: 99%

Progress of Circulating Tumor Cells in Cancer Management

Zhang

Wang

Guan

et al. 2015

Technol Cancer Res Treat

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Circulating tumor cells are low-frequency cells that are shed into the peripheral bloodstream from a primary solid tumor and/or metastasis. Although these cells were recognized initially in 1869, it is only in the past 2 decades that they have been isolated for use as a surrogate biomarker to monitor response to therapy, evaluate prognosis, detect tumor mutations, assist in selecting personalized medicine, and enable earlier cancer diagnosis.

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Time-Varying Pattern of Postoperative Recurrence Risk of Early-Stage (T1a-T2bN0M0) Non-Small Cell Lung Cancer (NSCLC): Results of a Single-Center Study of 994 Chinese Patients

Cited by 18 publications

References 48 publications

Time-Varying Pattern of Mortality and Recurrence from Papillary Thyroid Cancer: Lessons from a Long-Term Follow-Up

Time-Varying Pattern of Mortality and Recurrence from Papillary Thyroid Cancer: Lessons from a Long-Term Follow-Up

Prognostic significance of ABCB1 in stage I lung adenocarcinoma

Progress of Circulating Tumor Cells in Cancer Management

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