Clinicopathologic features of local and metastatic recurrences in primary lung adenocarcinoma

We attempted to construct the contour of recurrence in primary lung adenocarcinoma with clinicopathologic variables based on data of 131 patients with completely resected primary lung adenocarcinoma. In univariate analysis, tumor size (more or less 3 cm in diameter), p-T, p-N, pathological stage, differentiation, ly factor and v factor were chosen for prognostic predictors. In multivariate analysis, v factor and p-N were independent variables of local recurrence and metastatic recurrence, respectively. The examination of significant correlation among clinicopathologic variables in terms of 5-year survival rates of patients showed that tumor size, p-T, ly factor and v factor were profoundly related to local recurrence, whereas ly factor, differentiation and p-N were linked to distant metastasis. We therefore examined an additive effect of tumor size, differentiation and vascular invasion on recurrence. The results demonstrated that neither local nor metastatic recurrences were found in patients with well differentiated adenocarcinoma less than 3 cm in diameter if vascular invasion was negative. We conclude that vascular (ly factor and v factor) is central to lung adenocarcinoma recurrence. The vascular invasion is a powerful predictor of recurrence in less than 3 cm diameter, well differentiated adenocarcinoma of the lung.