EP1.08-06 Postoperative Oligo-Recurrence of Non-Small Cell Lung Cancer

Abstract

Postoperative recurrences of non-small cell lung cancer (NSCLC) are usually disseminated and systemic. The concept of oligo-recurrence, defined as a small number of new lesions at a distant site theoretically curable by local therapy, has recently been proposed for several cancers. The aim of this study was to clarify clinical features and outcomes of patients with postoperative oligo-recurrence of NSCLC. From 364 patients who underwent resection for NSCLC between January 2008 and December 2017 at our hospital. A total of 43 patients who developed recurrence were included in this study. Oligo-recurrence was defined as 1-2 loco-regional or distant recurrence lesions restricted to a single organ. Other recurrences were classified as poly-recurrence. Local therapy included surgery, stereotactic radiotherapy and radiotherapy. Oligo-recurrence was identified in 12 (27.9%) patients, mainly as a solitary recurrence (n=11, 91.7%) in regional lymph nodes (n=1), surgical stump (n=2), brain (n=5), lung (n=1), bone (n=2) and liver (n=1). Primary tumor histopathological types included 9 cases of adenocarcinoma, one case of squamous cell carcinoma, one case of pulmonary pleomorphic carcinoma and one case of large cell neuroendocrine carcinoma.The patients with oligo-recurrence had a longer time to recurrence than those with poly-recurrence (median: 23.5 months, 11.0 months). A case of mediastinal lymph node recurrence was performed radiation therapy. A case of surgical stump recurrence underwent lobectomy and other case was performed concurrent chemo-radiotherapy. 4 case of brain metastasis were underwent tumor resection and were performed stereotactic radiotherapy, one case of brain metastasis was performed stereotactic radiotherapy only. A case of lung metastasis underwent wedge resection and was used EGFR-TKI. A case of bone recurrence was performed radiation therapy and was used EGFR-TKI, other case was performed concurrent chemo-radiotherapy. A case of liver metastasis underwent tumor resection. 7 of 12 cases confirmed re-recurrence after local therapy. But 9 patients were alive between 30.4 and 110.0 months after local therapy, whereas three of 5 brain metastatic patients died between 24.9 and 71.8 months. The 5 year overall survival rates after local therapy were 81.5%. The presence of oligo-recurrence can predict a favorable prognosis in patients with NSCLC treated with aggressive local therapy.