Site of Recurrence in Patients with Stages I and II Carcinoma of the Lung Resected for Cure

Ninety-nine patients with Stage I or II lung carcinoma that was other than the small cell type and who survived for more than 30 days after a “curative” resection were followed for five years or until death if it occurred prior to the five-year anniversary. Recurrent disease developed in 44 patients. Clinical data and data from postmortem examination were reviewed in these 44 patients in an attempt to classify each recurrence as either initially local or distant metastatic disease. The site of the first documented recurrence was local in 18 patients and distant metastases in 26. When the patients with recurrence were separated into TNM categories, it was apparent that in those patients without lymph node metastases demonstrated in the resected specimen (N0), the initial recurrence tended to be a distant metastases, whereas in those with such involvement (N1), the initial occurrence was more often local. In light of these data, selection of appropriate initial adjuvant therapeutic modalities may be different for each type of patient.