title: Detection of Recurrence Patterns After Wedge Resection for Early Stage Lung Cancer: Rationale for Radiologic Follow-Up.
abstract: BACKGROUND
  Wedge resection for selected patients with early stage non-small cell lung cancer is considered to be a valid treatment option. The aim of this study was to evaluate the recurrence patterns after wedge resection, to analyze the survival of patients under routine follow-up, and to recommend a follow-up regimen.
  
  
  METHODS
  A retrospective analysis was done of 446 consecutive patients between May 2000 and December 2012 who underwent a wedge resection for clinical stage I non-small cell lung cancer. All patients were followed up with a computed tomography scan with or without contrast. The recurrence was recorded as local (involving the same lobe of wedge resection), regional (involving mediastinal or hilar lymph nodes or a different lobe), or distant (including distant metastasis and pleural disease).
  
  
  RESULTS
  Median follow-up for survivors (n = 283) was 44.6 months. In all, 163 patients died; median overall survival was 82.6 months. Thirty-six patients were diagnosed with new primary non-small cell lung cancer, and 152 with recurrence (79 local, 45 regional, and 28 distant). There was no difference in the incidence of recurrence detection detected by computed tomography scans with versus without contrast (p = 0.18). The cumulative incidence of local recurrences at 1, 2, and 3 years was higher than the cumulative incidence for local, regional, and distant recurrences: 5.2%, 11.1%, and 14.9% versus 3.7%, 6.6%, and 9.5% versus 2.3%, 4.7%, and 6.4%, respectively. Primary tumor diameter was associated with local recurrence in univariate analysis.
  
  
  CONCLUSIONS
  Wedge resection for early stage non-small cell lung cancer is associated with a significant risk for local and regional recurrence. Long-term follow-up using noncontrast computed tomography scans at consistent intervals is appropriate to monitor for these recurrences.
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: andrea_bille@gstt.nhs.uk.
authors.forename: Andrea
authors.initials: A
authors.lastname: Billè
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Usman
authors.initials: U
authors.lastname: Ahmad
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Kaitlin M
authors.initials: KM
authors.lastname: Woo
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Kei
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Prasad
authors.initials: P
authors.lastname: Adusumilli
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: James
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: David R
authors.initials: DR
authors.lastname: Jones
authors.affiliation: Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Nabil Pierre
authors.initials: NP
authors.lastname: Rizk
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy; D009519:New York City; D011013:Pneumonectomy / Q000379:methods*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods