Objective: To explore the postoperative recurrence patterns in the patients undergoing potentially curative resection of stage IIIA-N2 non-small cell lung cancer (NSCLC).
Methods: A total of 63 patients underwent curative operation from September 2004 to December 2008 at Peking University First Hospital and were pathologically diagnosed as stage IIIA-N2 NSCLC. Their clinical data were retrospectively reviewed. The follow-ups were conducted to detect the recurrent lesions. The recurrence rates at Year 2-3 were calculated by the Kaplan-Meier method while the Cox proportional hazard model was used to assess the risk factors associated with recurrence.
Results: The 2 and 3-year recurrence rate was 46.6% and 57.3% respectively. Only one patient experienced local failure. However, the predominant recurrence pattern was distant failure (27/28). As demonstrated by the univariate Cox regression analysis, 4 significant factors associated with recurrence and the arm of lymphatic or vascular invasion (LVI), number of positive N2 station > 1, number of positive node > 3 and involvement of subcarinal lymph nodes were found to increase the risks of failure (P < 0.05).
Conclusion: Distant failure is the predominant pattern of postoperative recurrence in the patients of stage IIIA-N2 NSCLC. In addition to LVI, the level of positive N2 station, the number of positive N2 node and the involvement of subcarinal lymph nodes are associated with the postoperative risk of recurrence.