Margriet Kwint

Chapter 3 58 Treatment of the metastases N (%) Bone 1 Adrenal & pulmonary 1 Surgery 5 (5.5%) Brain 2 Adrenal gland 2 Gamma knife 2 (2.2%) Brain 2 RFA 1 (1.1%) Liver 1 Overall survival and progression free survival After a median follow-up of 35 months (range 3-89, 95%CI 23-47), 42% (N=38) of the patients died. Sixty-nine percent (N=63) of the patients developed recurrence disease of whom 59% died. One patient died without any recurrence detected after 15 months. Most recurrences where within the thorax (N=28, 44%), brain (N=22, 35%) and adrenal gland (N=8, 13%). Eleven (12%) recurrences occurred within the irradiated area, of which 6 (7%) were within the thorax and 5 recurrences occurred at the location of the metastasis (5%). Thirty-nine patients (43%) had a recurrence in same organ which was affected at diagnosis. At the time of analysis, 58% (N=53) patients were alive, with a median follow-up of 18 months (range 3-89, 95% CI 12-24). Twenty-seven (51%) of those had no recurrence after a median active follow-up of 10 months (range 3-89, 95% CI 5-15). For the whole group, the median PFS was 14 months (range 2-89, 95% CI 12-16) and the median OS was 32 months (range 3-89, 95% CI 25-39). The 1- and 2-year OS were 85% and 58%, respectively. The 1- and 2-year PFS were 55% and 27%, respectively ( Figure 1 and 2 ). Univariate Cox proportional hazard analyses showed that squamous cell carcinoma (HR: 3.21, 95%CI: 1.26 – 8.14) and WHO-PS 1-2 (HR: 2.25, 95%CI: 1.15 – 4.40) were significantly associated with a lower OS. With respect to PFS, a higher T-stage (HR: 2.75, 95%CI: 1.25 – 6.08) was significantly associated with lower PFS (Table 4). In multivariate analyses, squamous cell carcinoma (HR: 3.63, 95%CI: 1.42 – 9.28) and WHO PS (HR: 2.51, 95%CI: 1.25 - 5.05) remained significant predictors for OS. For PFS, a higher T-stage (HR: 2.75, 95%CI: 1.25 – 6.08) remained as the only significant parameter in multivariate analyses ( Table 4 ). There were no significant correlations between a higher T-stage and the development of distant metastasis or local recurrences.