Detection of recurrence patterns after wedge resection for early stage lung cancer: Rationale for radiologic follow-up Journal Article

Authors: Billè, A.; Ahmad, U.; Woo, K. M.; Suzuki, K.; Adusumilli, P.; Huang, J.; Jones, D. R.; Rizk, N. P.
Article Title: Detection of recurrence patterns after wedge resection for early stage lung cancer: Rationale for radiologic follow-up
Abstract: Background Wedge resection for selected patients with early stage non-small cell lung cancer is considered to be a valid treatment option. The aim of this study was to evaluate the recurrence patterns after wedge resection, to analyze the survival of patients under routine follow-up, and to recommend a follow-up regimen. Methods A retrospective analysis was done of 446 consecutive patients between May 2000 and December 2012 who underwent a wedge resection for clinical stage I non-small cell lung cancer. All patients were followed up with a computed tomography scan with or without contrast. The recurrence was recorded as local (involving the same lobe of wedge resection), regional (involving mediastinal or hilar lymph nodes or a different lobe), or distant (including distant metastasis and pleural disease). Results Median follow-up for survivors (n = 283) was 44.6 months. In all, 163 patients died; median overall survival was 82.6 months. Thirty-six patients were diagnosed with new primary non-small cell lung cancer, and 152 with recurrence (79 local, 45 regional, and 28 distant). There was no difference in the incidence of recurrence detection detected by computed tomography scans with versus without contrast (p = 0.18). The cumulative incidence of local recurrences at 1, 2, and 3 years was higher than the cumulative incidence for local, regional, and distant recurrences: 5.2%, 11.1%, and 14.9% versus 3.7%, 6.6%, and 9.5% versus 2.3%, 4.7%, and 6.4%, respectively. Primary tumor diameter was associated with local recurrence in univariate analysis. Conclusions Wedge resection for early stage non-small cell lung cancer is associated with a significant risk for local and regional recurrence. Long-term follow-up using noncontrast computed tomography scans at consistent intervals is appropriate to monitor for these recurrences. © 2016 The Society of Thoracic Surgeons
Journal Title: Annals of Thoracic Surgery
Volume: 102
Issue: 4
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2016-10-01
Start Page: 1067
End Page: 1073
Language: English
DOI: 10.1016/j.athoracsur.2016.04.056
PROVIDER: scopus
PUBMED: 27345095
PMCID: PMC5421376
Notes: Conference Paper --Presented at the Fifty-second Annual Meeting of The Society of Thoracic Surgeons which took place Jan 23–27, 2016 in Phoenix, AZ -- Export Date: 1 November 2016 -- Source: Scopus
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MSK Authors
  1. Nabil Rizk
    131 Rizk
  2. James Huang
    118 Huang
  3. Kei Suzuki
    28 Suzuki
  4. Usman Ahmad
    9 Ahmad
  5. David Randolph Jones
    150 Jones
  6. Kaitlin Marie Woo
    97 Woo
  7. Andrea   Bille
    5 Bille