Factors influencing postoperative recurrence of early-stage non-small cell lung cancer

Abstract

Purpose

This study aims to explain the factors that may influence recurrence after surgical resection for early non-small cell lung cancer (NSCLC).

Methods

A retrospective analysis was made of 302 patients who underwent lung resection for stage I–IIA NSCLC in our clinic between January 2014 and August 2021.

Results

The recurrence rate was higher in patients with squamous cell carcinoma (SCC) than in those with adenocarcinoma (AC) (p = 0.004). Disease-free survival (DFS) was shorter in SCC (p = 0.004). According to histopathological subtypes, the presence of lymphovascular invasion (LVI), vascular invasion (VI), visceral pleural invasion (VPI) and tumor spread through air spaces (STAS) caused an increased risk of recurrence ((p = 0.004), (p = 0.001), (p = 0.047), (p = < 0.001)) and shorter DFS ((p = 0.002), (p = < 0.001), (p = 0.038), (p = < 0.001)). LVI and VI was more common in patients with distant recurrence (p = 0.020, p = 0.002), while the STAS was more common with locoregional recurrence (p = 0.003).

Conclusion

The presence of LVI, VI, VPI, and STAS are negative risk factors for recurrence and DFS in all patients and in patients with AC. In patients with SCC, the diagnosis of SCC itself and the presence of STAS were risk factors for recurrence and DFS. Moreover, the risk of distant recurrence is higher in the presence of LVI or VI, and the risk of locoregional recurrence in the presence of STAS is higher.

Keywords:

• Non-small cell lung cancer
• recurrence
• survival
• histopathology
• STAS
• surgery

Acknowledgements

The authors are grateful to Ege University Faculty of Medicine Department of Thoracic Surgery doctors, nurses and staffs for their collaboration.

Authors’ contributions

The authors responsibilities were as follows; T.I.A and A.K.T designed the research. All authors conducted the research, analysed the data, assisted with data interpretation; wrote the paper, participated in revision of the manuscript. T.I.A had primary responsibility for final content. All authors read and approved the final manuscript.

Disclosure statement

The authors declare no conflict of interest with respect to the authorship and/or publication of this article.

Data availability statements

The dataset of the research presented in this article is under record. Corresponding author can be contacted to reach the required data network.