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Objectives <p>Although several studies have examined risk factors for predicting recurrence sites after complete resection of primary lung cancer, few reports have explored the clinicopathological features of cases that develop postoperative recurrence after radical resection. We clinically defined recurrent lung cancer cases following resection as tumors that had demonstrated metastatic potential and aimed to clarify their biological dynamics according to the initial recurrence site.</p> Methods <p>A total of 122 patients who developed postoperative recurrence after pathologically confirmed R0 resection were retrospectively analyzed. Based on the initial site of recurrence, we examined associations between clinically diagnosed recurrent lung cancer and clinicopathological factors at the time of resection, as well as postoperative and post-recurrence prognosis.</p> Results <p>Among patients with brain metastases as the initial recurrence site (n = 20), lymph node metastasis and negative programmed death-ligand 1 expression were independent factors. Clinically diagnosed intrapulmonary recurrence occurred in 29 patients and was more frequent in women and never-smokers. Liver recurrence (n = 12) was significantly associated with non-adenocarcinoma histology. No clinicopathological factors were associated with adrenal recurrence (n = 9). Bone recurrence (n = 21) was more common in patients who underwent standard resection, whereas intrathoracic lymph node recurrence (n = 41) was more frequent in men. Multivariate analysis revealed that pleural dissemination recurrence (n = 19) was independently associated with lymph node-negative status and pleural invasion at the time of surgery. Patients with liver or bone metastases had significantly poorer postoperative and post-recurrence survival than those with recurrence in other organs, with particularly unfavorable outcomes observed in patients with non-adenocarcinoma liver metastases.</p> Conclusions <p>These findings suggest that organ-specific recurrence patterns are associated with distinct clinicopathological features and prognosis, and may help optimize postoperative surveillance and treatment strategies.</p>

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Organ-specific patterns and prognostic impact of lung cancer recurrence after complete resection

  • 期刊论文

  • 发表日期：

    2026年3月31日

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  • Yuto Watanabe,
  • Tomonari Kinoshita,
  • Lulu Li,
  • Yu Suyama,
  • Maki Nakashima,
  • Ai Otani,
  • Yo Tsukamoto,
  • Takamasa Shibazaki,
  • Takeo Nakada,
  • Takashi Ohtsuka

摘要

Objectives

Although several studies have examined risk factors for predicting recurrence sites after complete resection of primary lung cancer, few reports have explored the clinicopathological features of cases that develop postoperative recurrence after radical resection. We clinically defined recurrent lung cancer cases following resection as tumors that had demonstrated metastatic potential and aimed to clarify their biological dynamics according to the initial recurrence site.

Methods

A total of 122 patients who developed postoperative recurrence after pathologically confirmed R0 resection were retrospectively analyzed. Based on the initial site of recurrence, we examined associations between clinically diagnosed recurrent lung cancer and clinicopathological factors at the time of resection, as well as postoperative and post-recurrence prognosis.

Results

Among patients with brain metastases as the initial recurrence site (n = 20), lymph node metastasis and negative programmed death-ligand 1 expression were independent factors. Clinically diagnosed intrapulmonary recurrence occurred in 29 patients and was more frequent in women and never-smokers. Liver recurrence (n = 12) was significantly associated with non-adenocarcinoma histology. No clinicopathological factors were associated with adrenal recurrence (n = 9). Bone recurrence (n = 21) was more common in patients who underwent standard resection, whereas intrathoracic lymph node recurrence (n = 41) was more frequent in men. Multivariate analysis revealed that pleural dissemination recurrence (n = 19) was independently associated with lymph node-negative status and pleural invasion at the time of surgery. Patients with liver or bone metastases had significantly poorer postoperative and post-recurrence survival than those with recurrence in other organs, with particularly unfavorable outcomes observed in patients with non-adenocarcinoma liver metastases.

Conclusions

These findings suggest that organ-specific recurrence patterns are associated with distinct clinicopathological features and prognosis, and may help optimize postoperative surveillance and treatment strategies.