Local and/or distant recurrences in T1-2/N0-1 non-small cell lung cancer

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Abstract
Data from a series of 181 patients subjected to long-term follow-upafter surgical resection for non-small cell stage I and II lung cancer wereanalyzed to evaluate the statistical incidence and the prognostic factorsof recurrence. The recurrence rate/year was particularly high in the first2 years after surgery: the 2-year recurrence rate was 35.1% in stage Itumors and 51.8% in stage II, whereas the 5- and 7- year recurrence rateswere 46.1 and 55.9% and 65.8 and 70.7%, respectively, for the same groups.Recurrences were observed more frequently in non-epidermoid carcinomas withmultiple nodules (100% at 5 years) and in carcinomas classified as stage II(70.7% at 5-7 years), particularly when defined as adenocarcinoma (100% at3 years). In the overall recurrence rate we observed no significantdifference dependent on the type of resection even though limited segmentalor wedge resection appeared to be related to a higher risk rate (truerecurrence rate ratio: 0.6). Over two-thirds of the first observedrecurrences were located at a distant site, with a slightly higherincidence of non- epidermoid carcinoma (72.5%). Isolated local recurrencemostly occurred in epidermoid carcinoma (47.6%). The most frequent sites ofrecurrence were the brain, bone and mediastinum. On multivariate analysis,independently significant adverse prognostic factors regarding therecurrence incidence were: tumor size greater than 3 cm, bronchial or hilarlymph node involvement, tumor histologically defined as adenocarcinoma, andthe presence of satellite nodules.

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