Risk of Pleural Recurrence in Early-Stage Non-small Cell Lung Cancer in Patients Treated With Surgery vs Stereotactic Ablative Radiotherapy

Background: Pleural recurrence has been reported after thoracic surgery and radiation treatment, and reports show that the surgery as the first treatment may be associated with an increased incidence of pleural recurrence. The main objective of this study was to compare the incidence of ipsilateral pleural recurrence in patients with non-small cell lung cancer (NSCLC) who underwent surgical resection or curative-intent radiotherapy.

Methods: We performed a retrospective cohort study of patients aged 18 or older with stage I NSCLC who underwent surgical resection or curative-intent radiotherapy at our institution. The primary outcome of interest was an incidence of ipsilateral pleural recurrence at the time of first cancer recurrence. Secondary outcomes were the time of any first recurrence type of biopsy approach and the incidence of pleural recurrence.

Results: Our cohort included 512 patients for whom complete data were available. Of these, 50 (9.7%) patients experienced recurrence and 51 died during the five-year follow-up since their first treatment. There was no difference in the incidence of ipsilateral pleural recurrence (P=0.348), the incidence of any recurrence (P=0.069), or time to first recurrence (P=0.088) between the curative intent surgery and radiotherapy groups. Biopsy type was not associated with recurrence.

Conclusion: There was no difference in the incidence of ipsilateral pleural recurrence between the curative intent surgery and radiotherapy groups.