[Local recurrence in complete resection for non-small cell lung cancer]

307 patients with complete resection for non-small cell lung cancer between 1989 and 1996 were examined to evaluate the clinical features of local recurrence. Postoperative recurrence was observed in 104 of the 307 patients. At the first recurrence, local recurrences occurred in 21 (20%) of the 104 patients, distant metastases in 72 (69%), and combined recurrences in 11 (11%). 32 patients had local recurrences in 47 localizations, bronchial stump recurrences occurred in 11 (34%) of 47 localizations, hilarmediastinal lymph node metastases in 18 (56%), supraclavicular lymph node metastases in 10 (31%), contralateral mediastinal lymph node metastases in 1 (0%), and malignant effusion in 7 (22%). Lymph node metastases in the hilusmediastinum were the most common mode of the local recurrences (22%), and each mode of solely subclavian lymph node metastases and malignant effusion was 16%. The incidence of local recurrences increased as invasion into the lymphatic and/or blood vessels was demonstrated (p < 0.05). The results of our study implies that despite of lymph node dissection, latent disease persisted in the small lymphatic and/or blood vessels from hilus to subclavian sites. Postoperative adjuvant therapy including radiation will be beneficial to improvement of local control for patients invaded to lymph and/or blood vessels.