Analysis of the pattern of recurrence after curative thoracoscopic lobectomy of non-small cell lung cancer

Abstract

Objective To analysis the recurrence pattern after curative resection by thoracoscopic lobectomy of non-small cell lung cancer. Methods All patients who underwent lobectomy for clinical stage Ⅰ lung cancer determined by means of computed tomographic and positron emission tomographic analysis were identified from a prospective database at a single institution. All patients were selected for video-assisted thoracoscopic surgery. Patients’ characteristics, perioperative results, and recurrences were recorded. A logistic regression model was constructed to identify variables influencing the development of recurrent disease. Results There were 1 073 NSCLC patients who underwent curative thoracoscopic lobectomy between September 2006 and December 2013. 969 cases were included according to the inclusion criteria. 957 cases were included finally except for 12 cases without any follow-up information. The median follow-up time interval was 27 months(7-94 months). The overall recurrent rate is 17.6%(168/957), with 46.4%(78/168) distant recurrence, 38.7%(65/168) local recurrence, and 14.9%(25/168) synchronous distant and local recurrence. The most common local recurrent sites were: ipsilateral lung(53.8%), and mediastinal lymph node(36.6%). The most common distant recurrent sites were: contralateral lung(25.4%), bone(25.4%), and brain(17.5%). Univariate analysis showed that age ≥60 years, operation period, pathologic stage, tumor N stage, tumor T staging, and the degree of pathological differentiation were the factors influencing recurrence and metastasis after operation. Conclusion The recurrent pattern of thoracoscopic lobectomy for treating NSCLC is similar to thoracotomy. Thoracscopic lobectomy is a safe, feasible, and effective procedure for non-small cell lung cancer. The most common local recurrent sites are ipsileateral lung and mediastinal lymph node. The most common distant recurrnent sites are contralateral lung, bone and brain. Key words: Carcinoma, non-small-cell lung; Pneumonectomy; Thoracoscopy; Neoplasm recurrence, local; Neoplasm metastasis