Current Thoracic Surgery 2026 , Vol 11 , Issue 1
Prognostic factors for recurrence after surgical resection in early-stage nonsmall cell lung cancer
Gizem Özçıbık Işık1,Akif Turna2,Burcu Sena Aydın3,Boran Polat3,Burcu Kılıç2,Ezel Erşen2,Hasan Volkan Kara2,Mehmet Kamil Kaynak2
1Department of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Education and Research Hospital, Istanbul, Turkiye
2Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkiye
3Department of Emergency Medicine, Karamanoğlu Mehmet Bey University, Karaman, Türkiye
DOI : 10.26663/cts.2026.005 Viewed : 651 - Downloaded : 212 Background: Non-small cell lung cancer (NSCLC) constitutes the majority of lung cancer cases, with surgical resection being the main treatment for stages 1 and 2. Despite advances, postoperative recurrence remains a major cause of mortality. Identifying recurrence risk factors could allow individualized follow-up strategies.

Materials and Methods: We retrospectively analyzed 246 patients with stage 1-2 NSCLC who underwent surgery between 2005-2022. Stage 3 disease and neoadjuvant-treated cases were excluded. Clinical, laboratory, radiological, and surgical data were collected. Recurrences (locoregional or distant) within at least two years of follow-up were recorded. Comparisons were made using Student’s t-test or Chi-square test; survival was analyzed with Kaplan-Meier and Cox regression.

Results: VATS (Video-assisted thoracoscopic surgery) was more frequent in non-recurrence cases (p=0.017), while pneumonectomy was more common in recurrence cases (p=0.017). Advanced T and TNM stages, lymphatic and vascular invasion were significantly associated with recurrence. Cox regression identified N1 disease, pleural invasion, and lymphatic invasion as independent predictors of poor survival. Pneumonectomy and lymphatic invasion were significantly associated with reduced recurrence-free survival.

Conclusions: Recurrence after early-stage NSCLC surgery is linked to worse survival. Pneumonectomy and lymphatic invasion may predispose to recurrence, warranting closer follow-up and consideration of adjuvant therapy. Keywords : non-small cell lung cancer, early stage, recurrence, prognosis