Patterns of recurrence in resected non-small-cell lung cancer--emphasis on its relation to cell type and staging

Pulmonary resection remains the most effective treatment for patients with non-small-cell lung cancer. The purpose of this study is to determine the incidence, pattern, and site of lung cancer recurrence in patients surviving resection for non-small-cell lung cancer. One hundred ninety-eight patients with post-surgical non-small-cell lung cancer were followed up from 6.5 to 0.5 years (median: 2.0 years). Recurrent cancer developed in 103 patients (52.0%). Nineteen cases had local recurrence (9.6%) and 84 (42.4%) were distant metastasis. The incidence of recurrence increased with TN status, but there was no significant difference (P = 0.451) in the overall rate of recurrent lung cancer among the various TN staging. The overall recurrent rate of non-squamous cell lung cancer was 57.4%, which was higher than 47.7% in squamous cell lung cancer. Still, it made no significant difference among the various cell types (P = 0.058). Distant metastasis occurred most commonly to the bone (22.7%), then the contralateral lung (12.6%). Curative resection with accurate staging, appropriate adjuvant therapeutic modality and continued periodic surveillance are necessary in all patients who overcome the initial carcinoma.