Site-specific follow-up strategy for surgically resected patients with NSCLC based on ten-year follow-up data

Objectives

There is currently no consensus regarding the optimal site-specific postoperative follow-up duration for patients with completely resected non-small cell lung cancer. Long-term surveillance for recurrence may lead to psychological distress or economic burdens for patients.We aimed to propose an appropriate site-specific follow-up strategy for patients with non-small cell lung cancer based on 10-year follow-up data.

Materials and methods

We analyzed recurrence patterns in 2,359 patients with non-small cell lung cancer who underwent surgical resection from 2008 to 2013. We established potential site-specific follow-up endpoints when the subsequent recurrence rates fell below 5% and proposed a corresponding follow-up strategy.

Results

With a median follow-up of 111.0 months, postoperative recurrences were observed in 985 patients (41.8 %). We identified several factors associated with site-specific recurrence recurrence patterns, including ground-glass opacity component, sex, histology type, and pathological TNM stage. No recurrence was observed in patients with pure ground-glass nodules, a consolidation-to-tumor ratio less than 0.5, or a pathological type classified as lepidic pattern-predominant adenocarcinoma. In thorax, brain and bone, patients with non-squamous cell carcinoma exhibited higher recurrence rates than those with squamous cell carcinoma. In abdomen and neck, male patients have a higher recurrence rate than female patients, particularly within the pathological stage III group.

Conclusions

The follow-up strategy was developed based on the recurrence patterns analyzed from ten-year follow-up data. The online tool may assist in determining the optimal site-specific duration for surveillance based on clinicopathologic features.