RECURRENCE AFTER CURATIVE OPERATION FOR NON-SMALL-CELL LUNG-CANCER

The poor prognosis of bronchial carcinoma is reflected among other thi ngs in a high recurrence rate. In general, recurrence is inoperable an d only suitable for conservative/palliative management. The rate of cu rative surgical reintervention may be increased by early identificatio n of recurrence. The value of tumour follow-up and the role of reopera tion need to be assessed. 150 patients who underwent curative resectio n of non-small-cell lung cancer were followed-up for a mean of 4.5 Sea rs as part of a comprehensive after-care program. Fifty patients (33 % ) developed a recurrence at a mean of 13 months after operation. A sec ond curative resection was possible in 9 patients (6 %) with a mean su rvival of 22 months. Six of these patients had re-thoracotomy (complet ion pneumonectomy in 4 for local recurrence, mediastinal metastasectom y in 2), and in 3 patients a solitary cerebral metastasis was excised. Our results show that with focused, schematic tumour follow-up early recognition of recurrence is possible. Despite this, reoperation is on ly indicated in a selected group of patients because of multifocal rec urrence, or local or functional inoperability. Further intensification of tumour follow-up is limited by personnel, logistical, and financia l considerations. As an alternative, individualised, function-oriented tumour after-care could be considered.