Local recurrence following lung cancer surgery: Incidence, risk factors, and outcomes

Purpose: To date, few large-scale original studies have focused specifically on local recurrence following curative lung cancer surgery. This review seeks to consolidate and analyze data from these studies regarding local recurrence incidence, risk factors, salvage treatments, and outcomes to increase awareness in the Oncology community and to spark new research in this area. Methods: PubMed literature was searched for large-scale cohort studies involving recurrence following lung cancer surgery. Studies with a primary focus on local recurrence and studies that examined overall recurrence but provided relevant numerical data on local recurrence were included. Each chosen study's methods were critically analyzed to reconcile as best as possible large differences in reported results across the studies. Results: Up to 24% of patients recur locally following lung cancer surgery. Risk of local recurrence increases with the stage of the primary cancer, but even stage I patients experience local recurrence up to 19% of the time. Overall survival time following local recurrence varies widely across studies, from 7 to 26 months, and may be related to frequency of follow-up visits. Salvage therapy appears to increase survival time. However, estimates of this increase vary widely, and measurements of benefits of the various salvage options are confounded by lack of control of subjects' condition at the time of salvage therapy administration. Conclusions: Local recurrence following lung cancer surgery is a significant problem warranting additional research. At present, data on this topic is scarce. We recommend initiation of additional large-scale studies to clearly define the parameters of local recurrence in order to provide useful guidance to clinicians. (c) 2013 Elsevier Ltd. All rights reserved.