Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection

John M. Varlotto, Laura N. Medford-Davis, Abram Recht, John Flickinger, Nengliang Yao, Clayton Hess, Michael F. Reed, Jennifer Toth, Dani S. Zander, Malcolm M. DeCamp

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: An increasing proportion of patients with stage I non-small cell lung cancer (NSCLC) is undergoing sublobar resection (L-). However, there is little information about the risks and correlates of local recurrence (LR) after such surgery, especially compared with patients undergoing lobectomy (L+). Methods: Ninety-three and 318 consecutive patients with stage I NSCLC underwent L- and L+, respectively, from 2000 to 2006. Median follow-up was 34 months. Results: In the L- group, the LR rates at 2, 3, and 5 years were 13%, 24%, and 40%, respectively. The risk of LR was significantly associated with tumor grade, tumor size, and T stage. The crude risk of LR was 33.8% (21 of 62) for patients whose tumors were grade > 2. In the L+ group, the LR rates at 2, 3, and 5 years were 14%, 19%, and 24%, respectively. The risk of LR significantly increased with increasing tumor size, length of hospital stay, and the presence of diabetes. The L- group experienced a significant increase in failure in the bronchial stump/staple line compared with the L+ group (10% vs 3%; P = .04) and nonsignificant trends toward increased ipsilateral hilar and subcarinal failure rates. Conclusions: Patients with stage I NSCLC who undergo L- have an increased risk of LR compared with patients undergoing L+, particularly when they have tumors grade ≥ 2 or tumor size. > 2 cm. If L- is considered, additional local therapy should be considered to reduce this risk of LR, especially with tumors grade ≥ 2 or size > 2 cm.

Original languageEnglish (US)
Pages (from-to)1365-1377
Number of pages13
JournalCHEST
Volume143
Issue number5
DOIs
StatePublished - Jan 1 2013

Fingerprint

Non-Small Cell Lung Carcinoma
Recurrence
Neoplasms
Length of Stay

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Varlotto, J. M., Medford-Davis, L. N., Recht, A., Flickinger, J., Yao, N., Hess, C., ... DeCamp, M. M. (2013). Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection. CHEST, 143(5), 1365-1377. https://doi.org/10.1378/chest.12-0710
Varlotto, John M. ; Medford-Davis, Laura N. ; Recht, Abram ; Flickinger, John ; Yao, Nengliang ; Hess, Clayton ; Reed, Michael F. ; Toth, Jennifer ; Zander, Dani S. ; DeCamp, Malcolm M. / Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection. In: CHEST. 2013 ; Vol. 143, No. 5. pp. 1365-1377.
@article{03885b3d006f42708cee43dc58d7f01c,
title = "Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection",
abstract = "Objective: An increasing proportion of patients with stage I non-small cell lung cancer (NSCLC) is undergoing sublobar resection (L-). However, there is little information about the risks and correlates of local recurrence (LR) after such surgery, especially compared with patients undergoing lobectomy (L+). Methods: Ninety-three and 318 consecutive patients with stage I NSCLC underwent L- and L+, respectively, from 2000 to 2006. Median follow-up was 34 months. Results: In the L- group, the LR rates at 2, 3, and 5 years were 13{\%}, 24{\%}, and 40{\%}, respectively. The risk of LR was significantly associated with tumor grade, tumor size, and T stage. The crude risk of LR was 33.8{\%} (21 of 62) for patients whose tumors were grade > 2. In the L+ group, the LR rates at 2, 3, and 5 years were 14{\%}, 19{\%}, and 24{\%}, respectively. The risk of LR significantly increased with increasing tumor size, length of hospital stay, and the presence of diabetes. The L- group experienced a significant increase in failure in the bronchial stump/staple line compared with the L+ group (10{\%} vs 3{\%}; P = .04) and nonsignificant trends toward increased ipsilateral hilar and subcarinal failure rates. Conclusions: Patients with stage I NSCLC who undergo L- have an increased risk of LR compared with patients undergoing L+, particularly when they have tumors grade ≥ 2 or tumor size. > 2 cm. If L- is considered, additional local therapy should be considered to reduce this risk of LR, especially with tumors grade ≥ 2 or size > 2 cm.",
author = "Varlotto, {John M.} and Medford-Davis, {Laura N.} and Abram Recht and John Flickinger and Nengliang Yao and Clayton Hess and Reed, {Michael F.} and Jennifer Toth and Zander, {Dani S.} and DeCamp, {Malcolm M.}",
year = "2013",
month = "1",
day = "1",
doi = "10.1378/chest.12-0710",
language = "English (US)",
volume = "143",
pages = "1365--1377",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "5",

}

Varlotto, JM, Medford-Davis, LN, Recht, A, Flickinger, J, Yao, N, Hess, C, Reed, MF, Toth, J, Zander, DS & DeCamp, MM 2013, 'Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection', CHEST, vol. 143, no. 5, pp. 1365-1377. https://doi.org/10.1378/chest.12-0710

Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection. / Varlotto, John M.; Medford-Davis, Laura N.; Recht, Abram; Flickinger, John; Yao, Nengliang; Hess, Clayton; Reed, Michael F.; Toth, Jennifer; Zander, Dani S.; DeCamp, Malcolm M.

In: CHEST, Vol. 143, No. 5, 01.01.2013, p. 1365-1377.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection

AU - Varlotto, John M.

AU - Medford-Davis, Laura N.

AU - Recht, Abram

AU - Flickinger, John

AU - Yao, Nengliang

AU - Hess, Clayton

AU - Reed, Michael F.

AU - Toth, Jennifer

AU - Zander, Dani S.

AU - DeCamp, Malcolm M.

PY - 2013/1/1

Y1 - 2013/1/1

N2 - Objective: An increasing proportion of patients with stage I non-small cell lung cancer (NSCLC) is undergoing sublobar resection (L-). However, there is little information about the risks and correlates of local recurrence (LR) after such surgery, especially compared with patients undergoing lobectomy (L+). Methods: Ninety-three and 318 consecutive patients with stage I NSCLC underwent L- and L+, respectively, from 2000 to 2006. Median follow-up was 34 months. Results: In the L- group, the LR rates at 2, 3, and 5 years were 13%, 24%, and 40%, respectively. The risk of LR was significantly associated with tumor grade, tumor size, and T stage. The crude risk of LR was 33.8% (21 of 62) for patients whose tumors were grade > 2. In the L+ group, the LR rates at 2, 3, and 5 years were 14%, 19%, and 24%, respectively. The risk of LR significantly increased with increasing tumor size, length of hospital stay, and the presence of diabetes. The L- group experienced a significant increase in failure in the bronchial stump/staple line compared with the L+ group (10% vs 3%; P = .04) and nonsignificant trends toward increased ipsilateral hilar and subcarinal failure rates. Conclusions: Patients with stage I NSCLC who undergo L- have an increased risk of LR compared with patients undergoing L+, particularly when they have tumors grade ≥ 2 or tumor size. > 2 cm. If L- is considered, additional local therapy should be considered to reduce this risk of LR, especially with tumors grade ≥ 2 or size > 2 cm.

AB - Objective: An increasing proportion of patients with stage I non-small cell lung cancer (NSCLC) is undergoing sublobar resection (L-). However, there is little information about the risks and correlates of local recurrence (LR) after such surgery, especially compared with patients undergoing lobectomy (L+). Methods: Ninety-three and 318 consecutive patients with stage I NSCLC underwent L- and L+, respectively, from 2000 to 2006. Median follow-up was 34 months. Results: In the L- group, the LR rates at 2, 3, and 5 years were 13%, 24%, and 40%, respectively. The risk of LR was significantly associated with tumor grade, tumor size, and T stage. The crude risk of LR was 33.8% (21 of 62) for patients whose tumors were grade > 2. In the L+ group, the LR rates at 2, 3, and 5 years were 14%, 19%, and 24%, respectively. The risk of LR significantly increased with increasing tumor size, length of hospital stay, and the presence of diabetes. The L- group experienced a significant increase in failure in the bronchial stump/staple line compared with the L+ group (10% vs 3%; P = .04) and nonsignificant trends toward increased ipsilateral hilar and subcarinal failure rates. Conclusions: Patients with stage I NSCLC who undergo L- have an increased risk of LR compared with patients undergoing L+, particularly when they have tumors grade ≥ 2 or tumor size. > 2 cm. If L- is considered, additional local therapy should be considered to reduce this risk of LR, especially with tumors grade ≥ 2 or size > 2 cm.

UR - http://www.scopus.com/inward/record.url?scp=84877617223&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877617223&partnerID=8YFLogxK

U2 - 10.1378/chest.12-0710

DO - 10.1378/chest.12-0710

M3 - Article

C2 - 23715196

AN - SCOPUS:84877617223

VL - 143

SP - 1365

EP - 1377

JO - Chest

JF - Chest

SN - 0012-3692

IS - 5

ER -