Integrating Pathologic Stage and Perioperative Circulating Tumor Cell Variations: Early Relapse Prediction Model for Resectable Non-Small Cell Lung Cancer.

Abstract

The primary therapeutic objective for patients with resectable non-small cell lung cancer (NSCLC) is the prevention of disease relapse. This study aimed to examine the correlation between perioperative circulating tumor cell (CTC) variations and disease relapse. Ninety-nine patients with resectable NSCLC were enrolled and classified into cohort 0-1a and cohort 1b-4 on the basis of the presence of lymph node metastasis. CTC levels were measured, and their correlation with disease-free survival was analyzed. In cohort 0-1a, patients with a CTC count difference between postoperative day 3 and postoperation of <2.75, and a difference between postoperative day 3 and postoperation day 1 of <-0.25, showed no disease relapse. In cohort 1b-4, patients with a CTC count difference between postoperative day 3 and postoperation ≥6.25 had the highest risk of relapse, with all patients experiencing relapse within 2 years. For those with a difference <6.25, most relapses were identified within 2 years postoperation. The proposed relapse prediction model effectively identified patients with no risk for disease relapse in cohort 0-1a and those with the highest risk for relapse in cohort 1b-4. These results may assist physicians in focusing on and prescribing adjuvant treatment for patients with a higher relapse risk.