Gizem ÖZÇIBIK IŞIK, Akif TURNA, Burcu Sena AYDIN, Boran POLAT, Burcu KILIÇ, Ezel ERŞEN, Hasan Volkan KARA, Mehmet Kamil KAYNAK
Current Thoracic Surgery - 2026;11(1):37-44
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: V ATS (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.
