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

PURPOSE: 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.

MATERIALS AND METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.