Abstract
Clinical features of recurrence in patients with lung cancer were examined. Subjects were 232 patients, consisting of 124 adenocarcinomas, 87 squamous cell carcinomas, 13 large cell carcinomas and 8 small cell carcinomas. They underwent absolutely or relatively curative resection in our department between 1973 and 1985
Recurrent disease developed in 119 patients (51% of all examined patients) during the observation period (from the time of resection through 1988). The incidence of recurrence correlated better to the pN factor than to the pT factor.
Hematogenous metastasis occurred in 97 patients (42%). The lung, brain, and bone were the most frequent target organs of metastasis. Hematogenous metastasis developed in at least one of those three organs in 86% of cases.
Local recurrence appeared in 43 patients (19%). Lymphatic metastasis to the hilar, mediastinal, or supraclavicular lymphatic system was the most frequent pattern in local recurrence. Fewer patients showed recurrence at the surgical margin (3%), and pleural or pericardial dissemination (2%). There was no significant difference in the incidence of local recurrence among the four histological types of carcinoma. However, recurrence at the bronchial stump and pleural dissemination were characteristic for squamous cell carcinoma and adenocarcinoma, respectively.
In adenocarcinoma, of 67 patients with recurrence, 27 patients (40%) showed first recurrence more than 2 years postoperatively. However, in other types of carcinoma, only 17% of patients with recurrence were asymptomatic until 2 years or more postoperatively.
