What are the common reasons for treatment failure in patients with NSCLC

Postoperative recurrence is the most common cause of treatment failure in patients with NSCLC, and Taiwanese scholars Hung, Jung-Jyh conducted a study aimed at exploring the prognostic factors of patients who survived postoperative recurrence (PRS) of lung adenocarcinoma. (Journal of Thoracic Oncology, 2015, 10 (9):1328C1336) The study included 179 patients with postoperative recurrence of lung adenocarcinoma who attended Taipei Veterans General Hospital from 2004-2010, and retrospectively analyzed the prognostic, and predictive roles of the patients’ clinicopathological characteristics on PRS. There were 25 patients with local recurrence (15.4%), 56 patients with distant metastasis (34.6%), and 81 patients with local recurrence + distant metastasis (50.0%); 2-year and 5-year PRS were 65.2% and 29.8%, respectively; and the most common metastatic organs were the contralateral lungs (39.1%), the brain (33.5%), and the bone (31.3%). Multivariate analysis showed that micropapillary/solid-predominant tumors (HR = 2.615; 95% CI 1.395-4.901; P = 0.003 compared with vesicular/papillary-predominant tumors) had a shorter PRS in patients who did not receive treatment after recurrence (P < 0.001). However, for patients treated after recurrence, micropapillary/solid-predominant tumors (vs. vesicular/papillary tumors HR = 2.570; 95% CI 1.357-4.865; P = 0.004) were significant predictors of poor patient PRS. Surgical treatment after recurrence was expected to be a significant predictor of better PRS (p = 0.067). The study concluded that micropapillary/solid-dominant lung adenocarcinoma was a significant predictor of poor PRS prognosis compared with alveolar/papillary lung adenocarcinoma.