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The Annals of Thoracic Surgery, Vol 49, 242-246, Copyright © 1990 by The Society of Thoracic Surgeons
P Thomas and L Rubinstein
The Lung Cancer Study Group entered 907 eligible patients with T1 N0
non-small cell lung cancer in one of three successive clinical trials. At
the time of analysis, 201 of these patients were free from malignancy 60
months after operation. Thirty percent of patients who died were free from
malignancy at death. Death rates were comparable for the total group (907
patients) and the patients free from malignancy at 60 months (201 patients)
(0.086 versus 0.079, respectively); therefore death was not a suitable
therapeutic end point. Cancer recurrences were more frequent in patients
with non- squamous carcinoma than those with squamous carcinoma (0.088
versus 0.042); however, this difference was not observed after a 60-month
malignancy-free interval (0.035 versus 0.022, respectively). Select
comparisons between the total group of 907 patients and the 201 patients
free from malignancy at 60 months are noteworthy: (1) the rate of
occurrence of new, nonpulmonary malignancies was constant (0.016 versus
0.018, respectively); (2) the rate of pulmonary recurrences decreased
(0.043 versus 0.013, respectively); and (3) the rate of occurrence of new
lung cancer increased (0.009 versus 0.016, respectively). Therefore,
although cancer recurrences decreased with survival, new lung cancer
occurrences increased, and the probability of malignant disease appearing
more than 60 months after operation for T1 N0 non-small cell lung cancer
dictates continued patient surveillance.
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Cancer recurrence after resection: T1 N0 non-small cell lung cancer. Lung Cancer Study Group [published erratum appears in Ann Thorac Surg 1991 Mar;51(3):526]
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