title: The dynamic pattern of recurrence in curatively resected non-small cell lung cancer patients: Experiences at a single institution.
abstract: OBJECTIVE
  To investigate the hazard function of tumor recurrence in patients with completely (R0) resected non-small cell lung cancer.
  
  
  METHODS
  A total of 1374 patients treated between 2003 and 2009 with complete resection and systematic lymph node dissection were studied. The risk of recurrence at a given time after operation was studied utilizing the cause-specific hazard function. Recurrence was categorized as local recurrence or distant recurrence. The risk distribution was assessed using clinical and pathological factors.
  
  
  RESULTS
  The hazard function for recurrence presented an early peak at approximately 10 months after surgery and maintained a tapered plateau-like tail extending up to 8 years. A similar risk pattern was detected for both local recurrence and distant recurrence, while the risk of distant recurrence was higher than that of local recurrence. The double-peaked pattern of hazard rate was present in several subgroups, such as p-stage IA patients. A comparison of histology and status of nodal involvement showed that pN1-2 adenocarcinoma patients demonstrated a high hazard rate of distant recurrence and that pN0 adenocarcinoma patients exhibited a small recurrent risk for a longer time. Squamous cell carcinoma patients showed only little difference in risk.
  
  
  CONCLUSIONS
  The data may be useful to select patients at high risk of recurrence and may provide information for each patient to decide how to manage the postoperative follow-up individually.
authors.affiliation: Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany.
authors.forename: Yoshikane
authors.initials: Y
authors.lastname: Yamauchi
authors.affiliation: Translational Research Unit, Thoraxklinik, Heidelberg University, Heidelberg, Germany; Translational Lung Research Center Heidelberg, Heidelberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Muley
authors.affiliation: Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany.
authors.forename: Seyer
authors.initials: S
authors.lastname: Safi
authors.affiliation: Department of Radiation Oncology, Heidelberg University, Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Rieken
authors.affiliation: Department of Thoracic Oncology/Internal Medicine, Thoraxklinik, Heidelberg University, Heidelberg, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Bischoff
authors.affiliation: Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg University, Heidelberg, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Kappes
authors.affiliation: Institute of Pathology, Heidelberg University, Heidelberg, Germany; Translational Lung Research Center Heidelberg, Heidelberg, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Warth
authors.affiliation: Pneumology and Critical Care Medicine, Thoraxklinik, Heidelberg University, Heidelberg, Germany; Translational Lung Research Center Heidelberg, Heidelberg, Germany.
authors.forename: Felix J F
authors.initials: FJ
authors.lastname: Herth
authors.affiliation: Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Dienemann
authors.affiliation: Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany. Electronic address: hans.hoffmann@urz.uni-heidelberg.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Hoffmann
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies
keywords: Hazard function; Non-small cell lung cancer; Recurrence