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Song, Sohn, Kwak, Kim, Lee, Kim, Kim, Yoon, Shin, and Park: Clinicopathologic Characteristics of Recurrence after Curative-intent Surgical Therapy of Non-small Cell Lung Cancer
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2011; 70(4): 330-337.

Published online: 30 April 2011

DOI: https://doi.org/10.4046/trd.2011.70.4.330

Clinicopathologic Characteristics of Recurrence after Curative-intent Surgical Therapy of Non-small Cell Lung Cancer

Sung Heon Song, M.D., Jang Won Sohn, M.D., Ph.D., Hyun Jung Kwak, M.D., Sa Il Kim, M.D., Seung Ho Lee, M.D., Sang-Heon Kim, M.D., Ph.D., Tae Hyung Kim, M.D., Ph.D., Ho Joo Yoon, M.D., Ph.D., Dong Ho Shin, M.D., Ph.D., Sung Soo Park, M.D., Ph.D.

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Address for correspondence: Jang Won Sohn, M.D., Ph.D. Department of Internal Medicine, Hanyang University Guri Hospital, 249-1, Gyomun 1-dong, Guri 471-710, Korea. Phone: 82-31-560-2224, Fax: 82-31-555-2998, jwsohn@hanyang.ac.kr

Received 23 February 2011       Accepted 5 April 2011

Copyright © 2011. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Background

The clinicopathologic characteristics of patients with non-small cell lung cancer (NSCLC) have been changing. Recently, Positron emission tomography-computed tomography (PET-CT) has usually been used for diagnosis, follow-up to treatment and surveillance of NSCLC. We studied the pattern of recurrence and prognosis in patients who underwent complete resection for NSCLC according to histologic subtype.

Methods

All patients who underwent complete resection for pathological stage I or II NSCLC between January 2005 and June 2009 were identified and clinical records were reviewed retrospectively, especially the histologic subtype.

Results

Recurrences were identified in 50 of 112 patients who had complete resection of an NSCLC. Sites of recurrence were locoregional in 15 (30%), locoregional and distant in 20 (40%), and distant in 15 (30%). Also, sites of recurrence were intra-thoracic in 29 (58%), extrathoracic and intra-thoracic recurrence in 15 (30%), and extrathoracic in 6 (12%). In locoregional recurrence, there was 37% recurrence for non-squamous cell carcinoma (non-SQC) and 25% for squamous cell carcinoma (SQC). In distant recurrence, there was 39% recurrence for non-SQC and 18% for SQC. Locoregional recurrence in the bronchial stump was more common in SQC than non-SQC (14% vs. 45%, p=0.025). Prognosis of recurrence was not influenced by histologic subtype and the recurrence-free survival curve showed that the non-SQC group did not differ from the SQC group according to stage.

Conclusion

The prognosis for recurrence does not seem to be influenced by histologic types, but locoregional recurrence in the bronchial stump seems to be more common in SQC than non-SQC in completely resected stage I and II NSCLC.

Keywords: Carcinoma, Non-Small-Cell Lung, Recurrence, Prognosis, Histology

Figures and Tables

Figure 1
Recurrence-free survival curve shows that risk of recurrence does not differ between non-squamous and squamous cell carcinoma in stage I. SQC: squamous cell carcinoma.
trd-70-330-g001
Figure 2
Recurrence-free survival curve shows that risk of recurrence does not differ between non-squamous and squamous cell carcinoma in stage II. SQC: squamous cell carcinoma.
trd-70-330-g002
Table 1
Clinicopathologic characteristics of all patients
trd-70-330-i001

*Values are presented as number (%).

Table 2
Clinicopathologic characterisitics of patients with recurrence
trd-70-330-i002

*Values are presented as number (%).

RFS: recurrence free survival.

Table 3
Comparison of site of recurrence between non-squamous and squamous cell carcinoma
trd-70-330-i003

Values are presented as number (%).

SQC: squamous cell carcinoma.

Table 4
Comparison of site of intrathoracic recurrence between non-squamous and squamous cell carcinoma
trd-70-330-i004

Values are presented as number (%).

*Metastasis in ipsilateral peribronchial, ipsilateral hilar, ipsilateral intrapulmonary, ipsilateral mediastinal, ipsilateral subcarinal, contralateral mediastinal, or contralateral hilar lymph nodes.

SQC: squamous cell carcinoma.

Table 5
Comparison of site of extrathoracic recurrence between Non-SQC and SQC
trd-70-330-i005

Values are presented as number (%).

*Metastasis in ipsilateral or contralateral scalen, or supraclavicular lymph nodes.

SQC: squamous cell carcinoma.

Table 6
Univariate analysis for recurrence free survival
trd-70-330-i006

RFS: recurrence-free survival; SQC: squamous cell carcinoma.

Table 7
Multivariate Cox models for recurrence analysis
trd-70-330-i007

OR: odd ratio; CI: confidence interval; SQC: squamous cell carcinoma.

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