For patients with lung adenocarcinoma, a predominantly solid tumor subtype was associated with earlier recurrence and shorter postrecurrence survival (PRS). These patients were more likely to have more extrathoracic and multisite recurrences, according to a single-center retrospective record review of stage I lung adenocarcinoma patients who received surgical resection.
“Despite curative-intent surgical resection, tumor recurrence and spread remain the primary causes of cancer-related death among patients with early-stage lung cancer,” Dr. Hideki Ujiie of Memorial Sloan Kettering Cancer Center (New York), wrote in a study published online in Journal of Clinical Oncology.
To identify which tumor subtypes place patients at higher risk for recurrence after surgery, Dr. Ujiie and his colleagues reviewed records of 1,120 patients undergoing complete surgical resection for stage I lung adenocarcinoma from 1999 to 2009 at Memorial-Sloan Kettering Cancer Center.
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The 2-year PRS in the patients studied was 45%, with median PRS of just over 26 months; median follow-up was 60 months. On multivariable analysis, Dr. Ujiie and coauthors found that predominantly solid tumor type was the variable most strongly associated with worse PRS (HR 1.76, 95% CI 1.11-2.77, P = .016).
“The risk of recurrence for tumors with solid predominant histologic subtype peaked within 12 months and ... these tumors were associated with a higher incidence of extrathoracic, multiple-site recurrences in patients with stage I lung adenocarcinoma,” the investigators said (J Clin Oncol. 2015 Aug 10. doi:10.1200/JCO2015.60.9818).
The study was prompted, in part, by the new International Association for the Study of Lung Cancer, American Thoracic Society, and European Respiratory Society lung cancer classification system. The new classification schema recognizes the histologic heterogeneity of lung adenocarcinoma subtypes. Dr. Ujiie and his coauthors sought to use these characterizations to develop prognostic factors for recurrence risk and PRS. Their findings have clinical implications: “[R]egular surveillance is even more important when tumors of aggressive predominant subtypes (e.g., solid predominant histologic pattern) are present,” said Dr. Ujiie and his coauthors.
The National Institutes of Health and the U.S. Department of Defense supported the study. Dr. Chaft reported ties with DAVA Oncology, Myriad Genetics, Biodesix, Otsuka, and Eli Lilly. Dr. Sima is employed by Genentech/Roche. Dr. Huang received funding from Bristol-Myers Squibb. Dr. Rudin reported ties with AbbVia, Aveo Pharmaceuticals, Boehringer Ingelheim, GlaxoSmithKlin, Merck, Celgene, and BioMarin Pharmaceutical. Dr. Adusumilli received funding from Myriad Genetics. The other authors reported no disclosures.
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