title: Early and late recurrence after intentional limited resection for cT1aN0M0, non-small cell lung cancer: from a multi-institutional, retrospective analysis in Japan.
abstract: In 2015, we reported the outcomes of patients undergoing intentional limited resection (ILR) for non-small-cell lung cancer (NSCLC) from a retrospective, multi-institutional large database in Japan. Here, we analyse the clinicopathological characteristics of the patients extracted from this database with late recurrence and compare them with those with early recurrence.
  
  
  
  Of 1538 patients in the database with cT1aN0M0 NSCLC, 92 (6%) had recurrence. In this study, early recurrence was defined as recurrence within 5 years and late recurrence as recurrence beyond 5 years after surgery. We compared the clinicopathological characteristics and post-recurrence survival (PRS) between patients with early and late recurrence.
  
  
  
  Of the 92 patients with recurrence, 21 (23%) had late recurrence. Compared with the early recurrence group, there were significantly more adenocarcinomas and local recurrences in the late recurrence group (P = 0.04 for both). The 3- and 5-year PRS rates were 53 and 24%, respectively, and the median PRS period was 38 months. There were no significant differences in the PRS curves between patients with early and late recurrence (P = 0.12). Only 3 patients (0.2%) had recurrence more than 10 years after ILR. Of the 21 late-recurrence patients, 17 (81%) had tumours with a consolidation/tumour ratio (CTR) >0.25.
  
  
  
  Late recurrence occurred in 21 (23%) of 92 patients with recurrence after ILR for cT1aN0M0 NSCLC. Late recurrence was more likely to involve adenocarcinoma and local recurrence. It is thus considered reasonable to follow patients with a CTR >0.25 for 10 years after ILR.
authors.affiliation: Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan Division of Chest Surgery, Fukushima Medical University, Fukushima, Japan yukimatsumura1980@gmail.com.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Matsumura
authors.affiliation: Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Yano
authors.affiliation: Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Yoshida
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
authors.forename: Terumoto
authors.initials: T
authors.lastname: Koike
authors.affiliation: Department of Thoracic Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kameyama
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Shimamoto
authors.affiliation: Department of General Thoracic Surgery, National Hospital Organization Kobe Medical Center, Kobe, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Nishio
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshimoto
authors.affiliation: Department of Surgery, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Utsumi
authors.affiliation: Department of Thoracic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Shiina
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Department of Thoracic Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yamato
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Nishi-Niigata Chuo National Hospital, Niigata, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of General Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sonobe
authors.affiliation: Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Oda
authors.affiliation: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
authors.affiliation: Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tanahashi
authors.affiliation: Department of Thoracic Surgery, Hokkaido Cancer Center, Sapporo, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Adachi
authors.affiliation: Department of Thoracic Surgery, Tenri Hospital, Nara, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Saito
authors.affiliation: Department of Surgery and Clinical Science, Division of Chest Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
authors.forename: Masataro
authors.initials: M
authors.lastname: Hayashi
authors.affiliation: Department of Chest Surgery, Toho University Omori Medical Center, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Otsuka
authors.affiliation: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
authors.forename: Teruaki
authors.initials: T
authors.lastname: Mizobuchi
authors.affiliation: Division of Thoracic Surgery, Chiba Cancer Center, Chiba, Japan.
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Moriya
authors.affiliation: Department of Chest Surgery, Fukui Red Cross Hospital, Fukui, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Division of Thoracic Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Nishikawa
authors.affiliation: Division of Chest Surgery, Fukushima Medical University, Fukushima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology*; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014057:Tomography, X-Ray Computed
keywords: Intentional limited resection; Late recurrence; Non-small-cell lung cancer