Abstract
The patterns of recurrence after curative resection for pathologically stage I non-small cell lung cancer (NSCLC) were investigated according to the cell type. The medical records of stage I NSCLC patients who undergone curative resection at Asan Medical Center between 2000 and 2009 were reviewed. Total 940 patients with pathologically proven stage I NSCLC were included. Patients with lepidic-type adenocarcinoma (LTA) were 74, other adenocarcinoma (ADC) 580, and squamous cell carcinoma (SCC) 246. Median length of follow-up was 62 months (3∼189), median survival was 146 months, and median disease-free survival (DFS) was 109 months. During follow-up, recurrence occurred in 221 patients (23.5%). Number of recurrence is grouped by every 6 months. Incidence of recurrence was peaked within 2 years after resection, then gradually decreased thereafter. Recurrence LTA (AIS/MIA) group was significantly rare (13.5%) throughout the all follow-up period (median DFI of 60months), and its distribution shows relatively even distribution. Comparing ADC and SCC, ADC seemed to show better 5-year OS in univariate analysis (p=0.003), but not in multivariate analysis. Furthermore, there were no significant difference in 5-year DFS (p=0.331). ADC shows higher proportion of distant metastasis, even though ADC group has lower T-stage. SCC shows higher incidence of local recurrence. Recurrence of ADC occurred within 2 years after resection, and shows higher proportion of distant metastasis (74.0% Vs. 57.2) even though ADC group has lower T-stage. Most of recurrence of both ADC and SCC groups were peaked within 2 years after resection. LTA group shows significantly delayed pattern of recurrence.
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