title: Stage II-IV lung cancer cases with lymphovascular invasion relapse within 2 years after surgery.
abstract: OBJECTIVE
  For recurrent lung cancer, postoperative follow-up methods have not been adequately assessed, and no evidence-based postoperative surveillance methods currently exist. Herein, we evaluated postoperative lung cancer recurrence and the personalized postoperative surveillance periods and methods used.
  
  
  METHODS
  Follow-up after surgery consisted of a regular outpatient clinic check-up, including physical examination, history, blood tests, and chest X-ray, which were conducted three or four times per year for 5 years. During the follow-up period, annual chest and brain computed tomography scanning was performed. Between May 2004 and December 2011, 547 lung cancer patients underwent complete resection in our institution. We retrospectively reviewed their prospectively collected data.
  
  
  RESULTS
  We selected 106 patients (19.4 %) who had a postoperative recurrence. Multivariate analysis showed that advanced stage (stage II-IV; p < 0.01) and lymphovascular invasion positivity (LVI; p = 0.01) were independent risk factors for earlier recurrence. Overall, 90.8 % of patients with advanced-stage disease and LVI positivity experienced a relapse within 2 years after surgery, compared to 55.1 % of patients who did not have these factors (p < 0.01). Multivariate analysis showed that recurrence with symptoms (p < 0.01) and shorter time to recurrence (<24 months; p < 0.01) were independent prognostic factors after recurrence.
  
  
  CONCLUSIONS
  Although this study was retrospective and included some biases, patients with advanced-stage lung cancer and LVI positivity should be intensively followed up. Personalized follow-up programs should be considered for lung cancer patients who have undergone resection.
authors.affiliation: Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, 1800, Oazaaoyagi, Yamagata, 990-2292, Japan, sshiono@ypch.gr.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shiono
authors.forename: Naoki
authors.initials: N
authors.lastname: Kanauchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Yanagawa
authors.forename: Masami
authors.initials: M
authors.lastname: Abiko
authors.forename: Toru
authors.initials: T
authors.lastname: Sato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome