Postoperative oligo-recurrence of XXXX : clinical features and survival   .

@entity1 @entity5 @entity1149 @entity2 @entity1349
OBJECTIVES: Postoperative recurrences of @entity1149 ( @entity1149 ) are usually disseminated and systemic. Recently, the concept of oligo-recurrence, which is theoretically curable by definitive local therapy (DLT), has been proposed in several @entity5 . The aim of this study was to clarify clinical features and outcomes of @entity1 with postoperative oligo-recurrence of @entity1149 . METHODS: From 3275 @entity1 with resected pathological stage IA-IIIB @entity1149 between 1993 and 2011, a total of 768 @entity1 who developed recurrence were included in this study. Oligo-recurrence was defined as 1-3 loco-regional or distant recurrent lesions restricted to a single organ. Other recurrences were classified as poly-recurrence. Second @entity2 and suspected lesions were excluded. DLT included surgery, stereotactic radiotherapy and radiotherapy with a 45 Gy or higher dose, performed with curative intent. RESULTS: Oligo-recurrence was identified in 162 (21%) @entity1 , mainly as a solitary recurrence (n = 129, 80%) in regional lymph nodes, brain, lung, bone and adrenal gland, and the proportion of @entity1 with oligo-recurrence increased gradually year by year. The @entity1 with oligo-recurrence had more early-staged disease at initial surgery and a longer time to recurrence than those with poly-recurrence. The entire population of oligo-recurrence @entity1 had better @entity1349 ( @entity1349 ) than those with poly-recurrence (5-year @entity1349 : 32.9 vs 9.9%, P < 0.001). For oligo-recurrence, DLT was totally conducted in 105 (65%) @entity1 as initial treatment. Multivariate analyses revealed that the initial DLT was associated with improved @entity1349 [odds ratio (OR) 0.44; 95% confidence interval (CI) 0.29-0.68]. The recurrence location and initial pathological stage did not affect @entity1349 . The 5-year @entity1349 and postoperative progression-free survival rates after DLT were 38.6 and 22.3%, respectively. Of the 10 long-term (>= 5-year) progression-free survivors, 9 were those with a solitary recurrence. CONCLUSIONS: Initial DLT for oligo-recurrence achieved favourable @entity1349 in a selected population. Oligo-recurrence curable by DLT was found in a subset of @entity1 who received DLT, mostly as a solitary recurrence.
