Abstract
We investigated the incidence of late recurrence beyond 5years after pulmonary resection and aimed to identify candidates for long-term surveillance. We retrospectively reviewed the medical records of 978 non-small-cell lung cancer patients who underwent pulmonary resection between 2002 and 2015 and survived without recurrence for 5years. Clinicopathological factors associated with recurrence-free survival beyond 5years after surgery were investigated using univariate and multivariate analyses. The development of late metachronous malignancies was also investigated. The median follow-up period from 5years post-surgery was 27months in the whole cohort. Late recurrence occurred in 37 (3.8%) patients. Late metachronous malignancies were diagnosed in 116 patients (11.9%), including 57 (5.8%) with lung cancer. One-, three-, and five-year recurrence-free survival rates beyond 5years after surgery were 97.6%, 94.7%, and 94.7%, respectively. The recurrence-free survival of patients with pN1-2 was significantly poorer than that of patients with pN0 disease. Multivariate analysis revealed that adenocarcinoma and pN1-2 status were significantly associated with poor recurrence-free survival beyond 5years post-surgery (P = 0.009 and 0.007, respectively). Non-adenocarcinoma histology and pN0 status were significant favorable factors for recurrence-free survival beyond 5years post-surgery. The efficacies of long-term surveillance for the detection of late recurrence were considered limited for these populations. Twelve percent of the patients experienced late metachronous malignancies after pulmonary resection.
Published Version
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