Ultra-late recurrence of non-small cell lung cancer over 10 years after curative resection
Received 26 April 2019
Accepted for publication 20 June 2019
Published 19 July 2019 Volume 2019:11 Pages 6765—6774
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Kenan Onel
Dai Sonoda,1,2 Yosuke Matsuura,1 Junji Ichinose,1 Masayuki Nakao,1 Hironori Ninomiya,3 Mingyon Mun,1 Yuichi Ishikawa,3 Ken Nakagawa,1 Yukitoshi Satoh,2 Sakae Okumura1
1Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; 2Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan; 3Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan
Purpose: Most postoperative recurrences of non-small cell lung cancer (NSCLC) develop within 5 years after curative resection, with ultra-late recurrences developing over 10 years after the resection being rare. This study aimed to analyze the features of ultra-late recurrence in cases with NSCLC who had undergone curative resection.
Patients and methods: Among 1458 consecutive cases with NSCLC who underwent curative resection with systematic lymph node dissection during 1990–2006, 12 cases developed recurrence over 10 years after the resection. We defined the recurrence developing over 10 years after the resection as ultra-late recurrence and analyzed the factors related to it.
Results: Among the 1458 cases, recurrence developed in 476 (32.6%) cases. Of them, ultra-late recurrence developed in 12 (2.5%) cases. The ultra-late recurrence was histopathologically classified as adenocarcinoma in 11 cases and atypical carcinoid in 1 case. All cases were of invasive carcinoma. We compared ultra-late recurrence cases with non-recurrence cases and showed that none of the examined factors significantly influenced ultra-late recurrence; however, lymphatic invasion was close to significantly influencing it. There were two cases in which recurrence developed over 15 years after the resection; both cases were of adenocarcinoma with anaplastic lymphoma kinase (ALK) rearrangement.
Conclusion: There is a possibility of ultra-late recurrence developing over 10 years after the resection of any invasive NSCLC. Lymphatic invasion is close to significantly influencing ultra-late recurrence. Furthermore, a long follow-up period may be required in cases with adenocarcinoma with ALK rearrangement because it has the possibility of recurrence over 15 years after the resection.
Keywords: lung cancer, recurrence, resection, ALK rearrangement
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