Impact of Postoperative Oral Administration of UFT for Completely Resected pT2N0 Non-Small Cell Lung Cancer / 대한흉부외과학회지

BACKGROUND: Recent studies have suggested that UFT may be an effective adjuvant therapy for completely resected IB (pT2N0) non-small cell lung cancer (NSCLC). We designed this study to clarify the feasibility of performing adjuvant chemotherapy with UFT for completely resected IB non-small cell lung cancer. MATERIAL AND METHOD: We randomly assigned patients suffering with completely resected IB non-small cell lung cancer to receive either UFT 3g for 2 year or they received no treatment. All patients had to be followed until death or the cut-off date (December 31 2006). RESULT: From June 2002 through December 2004, 64 patients were enrolled. Thirty five patients were assigned to receive UFT(the UFT group) and 29 patients were assigned to observation (the control group). A follow-up survey on the 3 year survival rate was successfully completed for all the patients. The median follow-up time for all the patients was 32.8 months. In the UFT group, the median time of administration was 98 weeks (range: 2~129 weeks). The rate of compliance was 88.2% at 6 months, 87.5% at 12 months, 80.6% at 18 month and 66.7% at 24 months. Seven recurrences (24.1%) occurred in the control group and six (17.1%) occurred in the UFT group (p=0.489). The three-year disease free survival rate was 71.3% for the control group and 82.0% for the UFT group (p=0.331). On the subgroup analysis, the three-year disease free survival rate for the patients with adenocacinoma was 45.0% for the control group and 75.2% for the UFT group (p=0.121). The three-year disease free survival rate for the patients with non-adenocarcinoma was 88.1% for the control group and 88.9% for the UFT group (p=0.964). CONCLUSION: Postoperative oral administration of UFT was well-tolerated. Adjuvant chemotherapy with UFT for completely resected pT2N0 adenocarcinoma of the lung could be expected to improve the disease free survival, but this failed to achieve statistical significance. A prospective randomized study for a large number of patients will be necessary.

Risk Factors for Recurrence in Completely Resected pT1/2N1 Non-small Cell Lung Cancer / 대한흉부외과학회지

BACKGROUND: Complete surgical resection is the most effective treatment for pT1/2N1 non-small cell lung cancer, however 5 year survival rate of these patients is about 40% and the major cause of death is recurrent disease. We intended to clarify the risk factors of recurrence in completely resected pT1/2N1 non-small cell lung cancer. MATERIAL NAD METHOD: From Jan. 1990 to Jul. 2003, total of 117 patients were operated for pT1/2N1 non-small cell lung cancer. The risk of recurrence according to patients characteristics, histopathologic findings, type of resection, pattern of lymph node metastasis, postoperative adjuvant treatment were evaluated retrospectively. RESULT: Mean age of patients was 59.3 years. There were 14 patients with T1N1 and 103 patients with T2N1 disease. Median follow-up time was 27.5 months and overall 5 year survival rate was 41.3%. 5 year freedom-from recurrence rate was 54.1%. Recurrence was observed in 44 (37.6%) patients and distant recurrence developed in 40 patients. 5 year survival rate of patients with recurence was 3.3%, which was significantly lower than patients without recurrence (61.3%, p=0.000). In multi-variate analysis of risk factors for freedom-from recurrence rate, multi-station N1 (hazard ratio=1.997, p=0.047) was a poor prognostic factor. CONCLUSION: Multi-station N1 is the risk factor for recurrence in completely resected pT1/2N1 non-small cell lung cancer.

Prognostic Factors of Thymic Carcinoma / 대한흉부외과학회지

BACKGROUND: Thymic carcinoma is a rare malignant disease with sparse data for treatment and prognosis. We intended to investigate the prognostic factors of thymic carcinoma. MATERIAL AND METHOD: Data of 42 patients, who were diagnosed and treated for thymic carcinoma from January of 1986 to August of 2003 were reviewed retrospectively. Influences of characteristics of patients, Masaoka stage, histologic grade, completeness of resection and adjuvant treatment on survival were evaluated. RESULT: There were 30 male and 12 female patients and their mean age was 52.0+/-15.7 years old. There were 28 patients with low-grade histology and 13 patients with high- grade histology. Clinical stage according to Masaoka stage were I in 2, II in 2, III in 15 (35.7%), IVa in 10 (23.8%), and IVb in 13 (31%) patients. Surgical resection was done in 22 patients. Complete resection was possible in 13 patients and incomplete resection was done in 9 patients. Among 20 patients without resection, 8 patients received chemotherapy, 7 patients received radiotherapy and 5 patients received combined therapy. Median survival time was 31.7+/-6.1 months and 5 year survival rate was 28.6%. High grade histology (hazard ratio=3.009, 95% confidence interval=1.178~7.685, p=0.021) and incompleteness of resection (hazard ratio=3.605, 95% confidence interval=1.154~11.580, p=0.023) were the prognostic factors of thymic carcinoma. CONCLUSION: In thymic carcinoma, low grade histology is a good prognostic factor and complete resection can prolong the survival of patients.