P08.03 Clinicopathological Factors Associated With Recurrence Patterns of Resected Non-Small Cell Lung Cancer

Abstract

Even after complete resection, non-small cell lung cancer (NSCLC) shows preferential recurrence in the mediastinal lymph nodes, lungs, brain, bone, and liver. However, the relationship between clinicopathological factors and recurrence patterns after resection have not been well-evaluated. This study aimed to identify the relationship between clinicopathological factors at surgery and sites of postoperative metastasis in patients with completely resected NSCLC. 233 NSCLC cases with recurrence after complete resection between 2004 and 2016 at our institute were examined retrospectively. View Large Image Figure ViewerDownload Hi-res image Download (PPT) Multiple metastases were observed after the resection of advanced stage NSCLC at initial recurrence, and adenocarcinoma and the presence of lymphatic permeation would result in multiple metastases at final recurrence. Both at initial and final recurrence, NSCLCs with lymph node metastasis and pulmonary metastasis at surgery commonly recurred in the mediastinal lymph nodes and lungs, respectively. Young age, adenocarcinoma, and the presence of vascular invasion were correlated with brain metastasis. Although no variable was associated with bone metastasis, vascular invasion was correlated with postoperative liver metastasis. The presence of vascular invasion, larger invasive size, and advanced stage were independent risk factors of early recurrence. Considering survival, vascular invasion in addition to elderly age and non-adenocarcinoma were unfavorable prognostic factors after recurrence. Some clinicopathological variables were correlated with organ-specific metastasis and post-recurrence survival. Particularly, vascular invasion was a biomarker of brain and liver metastases and a prognostic marker after recurrence among completely resected NSCLC. This information is useful for patient follow-up and identifying organ-specific distant metastasis.