Certain characteristics of tumours in lung cancer patients are associated with a strong risk of cancer recurrence after surgery, according to a new study.
The researchers said these findings could help identify patients who will benefit from more extensive lung surgery, potentially reducing the risk of lung cancer recurrence by 75%. It could also help identify patients most likely to benefit from lung-sparing surgery.
The study authors examined tumours from more than 700 patients who had surgery for early-stage adenocarcinoma, the most common type of non-small cell lung cancer. Tumours in 40% of the patients had an abnormal cell pattern that was strongly associated with cancer recurrence after surgery.
Limited lung surgery may not be appropriate for patients with this micropapillary (MIP) pattern, the Memorial Sloan-Kettering Cancer Center researchers said. They found that patients with the MIP pattern had a 34% risk of their lung cancer returning within five years after lung-sparing surgery, or limited resection, in which the tumour is removed by minimally invasive means and lung function is preserved.
Handful of centres
In contrast, patients with the MIP pattern who had up to one-third of the lung removed along with the tumour, or lobectomy, had a 12% risk of cancer recurrence within five years.
The findings will appear in the 20 August issue of the Journal of the National Cancer Institute.
Only a handful of cancer centres in the United States have the expertise to identify the MIP pattern during surgery. Patients whose tumours are later found to have the MIP pattern after lung-sparing surgery may require further, more extensive surgery to reduce their risk of recurrence, the researchers said in a Memorial Sloan-Kettering news release.
They are working to develop new technology that can be used to identify which tumours have the MIP pattern before or during surgery.
Almost 250 000 patients are diagnosed with non-small cell lung cancer each year in the United States.
The American Lung Association has more about lung cancer.