Discovery May Help Pinpoint Risk of Lung Cancer Returning After Surgery

 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 percent. 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 percent 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 researchers said. They found that patients with the MIP pattern had a 34 percent 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.

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 percent risk of cancer recurrence within five years.

Only a handful of cancer centers  have the expertise to identify the MIP pattern during surgery. Patients whose tumors 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  news release.

They are working to develop new technology that can be used to identify which tumors have the MIP pattern before or during surgery.

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