Stage II-IV lung cancer cases with lymphovascular invasion relapse within 2 years after surgery

For recurrent lung cancer, postoperative follow-up methods have not been adequately assessed, and no evidence-based postoperative surveillance methods currently exist. Herein, we evaluated postoperative lung cancer recurrence and the personalized postoperative surveillance periods and methods used.

Follow-up after surgery consisted of a regular outpatient clinic check-up, including physical examination, history, blood tests, and chest X-ray, which were conducted three or four times per year for 5 years. During the follow-up period, annual chest and brain computed tomography scanning was performed. Between May 2004 and December 2011, 547 lung cancer patients underwent complete resection in our institution. We retrospectively reviewed their prospectively collected data.

We selected 106 patients (19.4 %) who had a postoperative recurrence. Multivariate analysis showed that advanced stage (stage II-IV; p < 0.01) and lymphovascular invasion positivity (LVI; p = 0.01) were independent risk factors for earlier recurrence. Overall, 90.8 % of patients with advanced-stage disease and LVI positivity experienced a relapse within 2 years after surgery, compared to 55.1 % of patients who did not have these factors (p < 0.01). Multivariate analysis showed that recurrence with symptoms (p < 0.01) and shorter time to recurrence (<24 months; p < 0.01) were independent prognostic factors after recurrence.

Although this study was retrospective and included some biases, patients with advanced-stage lung cancer and LVI positivity should be intensively followed up. Personalized follow-up programs should be considered for lung cancer patients who have undergone resection.