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The Journal of Thoracic and Cardiovascular Surgery, Vol 106, 1053-1058, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
PA Thomas Jr and L Rubinstein
Occurrences of malignancy in 308 patients who were clinically free of
cancer 60 months or more after surgical treatment of T1 N0 non-small- cell
lung cancer are summarized. At last report, 210 patients remained alive
with no evidence of malignant disease, 43 patients died of nonmalignant
causes, and 55 patients had 59 occurrences of malignant disease. Late lung
cancer recurrence was observed in 22 patients (concurrent with
nasopharyngeal cancer in one patient and with laryngeal cancer in one
patient). Metachronous second lung cancer was noted in 20 patients
(including concurrent colon cancer in one patient and metastatic recurrence
in one patient). Other nonpulmonary malignant tumors appeared in 13
patients. Including second lung cancer, 25 cancers of aerodigestive
epithelium were observed in 23 patients. The malignancy-free survival
advantage for patients with squamous cancer observed until 60 months after
resection was not sustained at 60 months and beyond. At the time of last
follow-up, 84 patients (27%) had died; 43 were free of malignancy, and 41
had malignancy (14 patients were alive with malignancy and 210 with no
evidence of disease). These data reinforce two conclusions: (1) The
probability of lung cancer recurrence or appearance of new lung cancer 5
years or more after successful operation in this select subpopulation of
patients with lung cancer is of concern. (2) The malignancy-free survival
advantage of patients with squamous cancer disappears after 5 years.
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Malignant disease appearing late after operation for T1 N0 non-small- cell lung cancer. The Lung Cancer Study Group
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