Risk factors for recurrence after lung cancer resection as estimated using the survival tree method
Menée sur 1 338 patients atteints d'un cancer du poumon traité par résection complète, cette étude rétrospective évalue l'association entre des facteurs du système de classification TNM, le sous-type histologique de la maladie, la présence d'un envahissement vasculaire et le risque de récidive
Background : Patients with lung cancer often present with recurrence, even after resection. The identification of risk factors for recurrence after resection is useful.
Methods : Among 1338 patients with lung cancer who underwent a complete resection, 277 developed recurrences post-surgery. Data regarding the TNM factors, histological subtype and the presence/absence of vessel invasion were analyzed retrospectively using the survival tree method to identify groups with a high risk of recurrence after resection.
Results : The results revealed that the T factor, the N factor, and lymphatic (ly) and blood (v) vessel invasion were related to the risk of recurrence and six combinations of these factors were identified using the survival tree method; Group A: v = 0, T <= 1b, ly = 0; Group B: v = 0, T <= 1b, ly >= 1; Group C: v = 0, T >= 2a; Group D: v >= 1, N <= 1,T <= 2b; Group E: v >= 1, N <= 1, T >= 3; and Group F: v >= 1, N >= 2. The six groups were then further classified into three groups: a low-risk group (Group A), a moderate-risk group (Groups B, C and D), and a high-risk group (Groups E and F). The 5-year recurrence-free survival rate was approximately 98% for the low-risk group, 75% for the moderate-risk group, and 30 % for the high-risk group.
Conclusions : Combining the T, N, v and ly factors allowed the precise identification of a group with a high risk of recurrence after resection.
Chest , résumé, 2012