Impact of the initial site of recurrence on prognosis after curative surgery for primary lung cancer

• Published in: European journal of cardio-thoracic surgery 2022-03, Vol.61 (4), p.778-786
• Main Authors: Isaka, Tetsuya, Ito, Hiroyuki, Nakayama, Haruhiko, Yokose, Tomoyuki, Saito, Haruhiro, Masuda, Munetaka
• Format: Article
• Language: English
• Subjects: Humans; Lung Neoplasms; Lymph Nodes - pathology; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Retrospective Studies
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezab442

This retrospective study aimed to elucidate the impact of the initial site of recurrence on relapse-free survival and post-recurrence survival (PRS) after the curative resection of primary lung cancer. We enrolled 325 patients who developed recurrence after curative resection of pathological stage I-IIIA primary lung cancer between January 2006 and December 2018 at the Kanagawa Cancer Center. Cases were classified as follows based on the initial site of recurrence: cervicothoracic lymph node (n = 144), lung (n = 121), pleural dissemination (n = 52), bone (n = 59), brain and meningeal dissemination (n = 50) and abdominal organ (n = 34) cases. The relapse-free survival and PRS of patients with and without recurrence at each site were compared using the log-rank test. The impact of the initial site of recurrence on PRS was analysed using the Cox proportional hazards model. Relapse-free survival was significantly poorer in patients with abdominal organ recurrence than in patients without abdominal organ recurrence (11.5 vs 17.6 months, P = 0.024). The PRS of patients with bone and abdominal organ recurrences was worse than that of patients without bone (18.4 vs 31.1 months, P