Prognosis of patients with recurrent nonsmall cell lung cancer who received the best supportive care alone

The development of treatments for non-small cell lung cancer (NSCLC) has remarkably progressed. Various treatment options are available for patients with postoperative NSCLC recurrence. However, some patients receive only the best supportive care (BSC) owing to their general condition and wishes, and their prognosis and associated factors remain unclear. We aimed to clarify the survival and prognostic factors in patients with recurring NSCLC who only received BSC. This study included 903 patients who underwent complete resection with lobectomy or more invasive resection and systematic lymph node dissection for NSCLC at the Kitasato University Hospital between 2004 and 2015; a total of 270 patients experienced recurrence. Of them, 49 patients received BSC only. We determined the overall survival (OS) and post-recurrence survival (PRS), as well as the associated prognostic factors. Patients who received BSC alone had a median survival time of 4 (0–86) months after recurrence. The 5-year OS rate was 32.7%; the PRS rates were 11.0% and 6.6% at 3 and 5 years, respectively. The multivariate analyses showed that the number of initial recurrent lesions (one or two), time to recurrence (>1 year), and performance status (0–1) were favorable prognostic factors for PRS. Good performance status was a prognostic factor in patients with recurrence as it affects the treatment choice; however, it was also a prognostic factor in those who received the best supportive care alone. To select the appropriate treatment methods, highly accurate prognostic prediction is necessary.