비소세포폐암 수술 후 세포분화도가 재발에 영향을 미친다
Cell Differentiation Might Predict the Recurrence in Surgically Resected Non-Small Cell Lung Carcinoma
조성근 (중앙대학교 의과대학 호흡기내과학교실)
이혜민 (중앙대학교 의과대학 호흡기내과학교실)
박성운 (중앙대학교 의과대학 호흡기내과학교실)
이병욱 (중앙의대)
이재희 (중앙대학교 의과대학 호흡기내과학교실)
김보민 (중앙대학교 의과대학 호흡기내과학교실)
박인원 (중앙대학교)
- 다운로드 수
- 조회수
Abstract
Background: Lung cancer is the most common cause of cancer mortality in Korea. The TNM stage at presentation in patients with non-small cell lung cancer (NSCLC) has the greatest impact on prognosis. Patients who undergo a complete resection for NSCLC are likely to develop recurrent and/or metastatic disease. There are several factors influencing the development of recurrence. We explored risk factors of recurrence in patients with stages I and II NSCLC, who had undergone curative resection. Methods: We reviewed patients who had complete surgical resection as definitive treatment for stage I or II. Patients followed up for more than 36 months. We evaluated several factors which might have relationship with recurrence, such as patient’s demographic factors, TNM staging, pathologic finding, tumor markers and surgical technique. Results: A total of 75 patients were enrolled for analysis, of whom 58 were men and 17 were women with mean age of 61 (range, 37 to 76) years. The average size of tumors was 3.9 cm (0.7 to 10 cm). There were 64 patients with stage I NSCLC and 11 with stage II NSCLC. Among 64 patients with stage I NSCLC, 35 patients showed recurrences whereas 8 patients have recurred in stage II NSCLC. Grade of differentiation of tumor was closely related to the recurrence. Seventy-five percent of patients who had poor tumor differentiation experienced a recurrence. In contrast, 3 patients of twelve had recurrences, who revealed differentiation in their tissue (p＜0.05). Conclusion: Tumor differentiation could be a predictive factor for tumor recurrence in patients who have undergone curative resection for stage I or II NSCLC.
- keywords
- Carcinoma, Non-Small-Cell Lung, Recurrence, Risk Factors, Cell Differentiation, Carcinoma, Non-Small-Cell Lung, Recurrence, Risk Factors, Cell Differentiation
참고문헌
1. Korea National Statistical Office. Annual report on the cause of death statistics, 2007. Daejeon: Korea National Statistical Office; 2008.
2. Hayat MJ, Howlader N, Reichman ME, Edwards BK.Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist 2007;12:20-37.
3. Asamura H, Goya T, Koshiishi Y, Sohara Y, Tsuchiya R, Miyaoka E. How should the TNM staging system for lung cancer be revised? A simulation based on the Japanese Lung Cancer Registry populations. J Thorac Cardiovasc Surg 2006;132:316-9.
4. Visbal AL, Leighl NB, Feld R, Shepherd FA. Adjuvant chemotherapy for early-stage non-small cell lung cancer.Chest 2005;128:2933-43.
5. Winton T, Livingston R, Johnson D, Rigas J, Johnston M, Butts C, et al. Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. N Engl J Med 2005;352:2589-97.
6. Scagliotti G. Multimodality approach to early-stage non-small cell lung cancer. Lung Cancer 2007;57 Suppl 2:S6-11.
7. Ou SH, Zell JA, Ziogas A, Anton-Culver H. Prognostic factors for survival of stage I nonsmall cell lung cancer patients: a population-based analysis of 19,702 stage I patients in the California Cancer Registry from 1989 to 2003. Cancer 2007;110:1532-41.
8. Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997;111:1710-7.
9. Greene FL. AJCC cancer staging manual. 6th ed. New York: Springer-Verlag; 2002.
10. Goldstraw P, Crowley J, Chansky K, Giroux DJ, Groome PA, Rami-Porta R, et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2007;2:706-14.
11. Rami-Porta R, Crowley JJ, Goldstraw P. The revised TNM staging system for lung cancer. Ann Thorac Cardiovasc Surg 2009;15:4-9.
12. Kobayashi N, Toyooka S, Soh J, Ichimura K, Yanai H,Suehisa H, et al. Risk factors for recurrence and unfavorable prognosis in patients with stage I non-small cell lung cancer and a tumor diameter of 20 mm or less. J Thorac Oncol 2007;2:808-12.
13. Tsuboi M, Ohira T, Saji H, Miyajima K, Kajiwara N, Uchida O, et al. The present status of postoperative adjuvant chemotherapy for completely resected non-small cell lung cancer. Ann Thorac Cardiovasc Surg 2007;13:73-7.
14. Pisters KM, Evans WK, Azzoli CG, Kris MG, Smith CA,Desch CE, et al. Cancer Care Ontario and American Society of Clinical Oncology adjuvant chemotherapy and adjuvant radiation therapy for stages I-IIIA resectable non small-cell lung cancer guideline. J Clin Oncol 2007;25:5506-18.
15. Kita H, Koshiishi Y, Masui K, Fujita A, Ootsuka K,Furuyashiki G, et al. Risk factors of recurrence in resected stage I non-small cell lung cancer. Kyobu Geka 2007;60:883-7.
16. Fujisawa T, Yamaguchi Y, Saitoh Y, Hiroshima K,Ohwada H. Blood and lymphatic vessel invasion as prognostic factors for patients with primary resected nonsmall cell carcinoma of the lung with intrapulmonary metastases. Cancer 1995;76:2464-70.
17. Pechet TT, Carr SR, Collins JE, Cohn HE, Farber JL.Arterial invasion predicts early mortality in stage I non-small cell lung cancer. Ann Thorac Surg 2004;78:1748-53.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수