Can lung cancer recurrence still be operated for a second time? How long can I live after lung cancer recurrence? Can lung cancer be cured after recurrence? Can a recurrence of ground glass nodule still be operated? How to prevent the recurrence of lung cancer? I. How high is the risk of lung cancer recurrence and is the recurrence rate of lung cancer high? Lung cancer is one of the malignant tumors with a higher degree of malignancy and has a higher risk of recurrence and metastasis. The risk of recurrence after surgery for stage IIIa lung cancer can reach 50-60%, 40-50% for stage II lung cancer, 20-30% for stage Ib, and about 10% for stage Ia. Adenocarcinoma in situ and microinvasive adenocarcinoma have almost no risk of recurrence, and the very few cases of recurrence are those who continue to smoke after surgery. II. Can lung cancer be cured after recurrence? After lung cancer recurrence, it depends on whether it is local recurrence or combined with distant metastasis. If it is only a local recurrence, there is still a chance to be cured. If it is combined with distant metastasis, systemic treatment is needed. C. What are the symptoms of lung cancer recurrence? Other common symptoms include: chest pain, coughing and sputum, elevated tumor markers (CEA), elevated MRD (what is MRD? It is a kind of regular review of blood, similar to tumor markers, but more sensitive, which can indicate recurrence of metastasis when there is no change in CT) Which CT manifestations, or PET descriptions, suggest recurrence of lung cancer? or PET description, suggest the possibility of lung cancer recurrence, for example, sudden enlargement of bronchial stump, enlarged hilar and mediastinal lymph nodes, new pleural effusion or pericardial effusion, or multiple nodules in the lung, or abnormal concentration on bone scan. Sites of lung cancer recurrence The sites of lung cancer recurrence and metastasis can be manifested in all parts of the body, the most common sites include: lung (ipsilateral lung, contralateral lung), hilar mediastinal lymph nodes, supraclavicular lymph nodes, abdominal lymph nodes, cervical lymph nodes, skull, adrenal gland, bone, liver, skin (manifested as subcutaneous nodes). D. How many years does it usually take for lung cancer to recur? The most common time of lung cancer recurrence is about 2-3 years after surgery. Therefore, the first three years after lung cancer surgery is the key time for follow-up observation. Chest CT is reviewed every three months or so, and head MRI, bone scan and abdominal ultrasound are reviewed once a year. V. How long can I live after lung cancer recurrence? It depends on the new staging after recurrence, and if it is advanced, it also depends on the efficacy of drug therapy, such as targeted therapy, or immunotherapy to determine the subsequent survival time. After recurrence, patients need to be re-staged, and the secondary staging of lung cancer, can predict survival time. For example, if it is a limited recurrence, newly staged, or stage I or II lung cancer, then there is still a chance for radical cure through surgical treatment, and the prognosis is better; if it is a stage III recurrence with mediastinal lymph node metastasis, active systemic treatment (chemotherapy/targeted therapy/immunotherapy for about 2-3 months) can be considered, and the 5-year survival rate of such patients was previously around 20-30%. In case of stage IV recurrence, the prognosis is equivalent to advanced lung cancer, and the survival time mainly depends on the site and number of distant recurrences, as well as the efficacy of drug therapy. (For details, please refer to another article by Dr. Xie.) Can lung cancer recurrence still lead to second surgery? If it is a local recurrence of lung cancer without mediastinal lymph node metastasis or distant metastasis, there is still a chance for surgery, that is, preoperative staging is needed again to assess whether it is early to mid-stage lung cancer and to exclude distant metastasis before surgery, which is often supplemented by chemotherapy or immunotherapy. In case of distant recurrence, if it is a single station metastasis, such as single brain metastasis, single adrenal metastasis, or single lung metastasis, surgical resection combined with systemic therapy can be considered. In case of multiple metastases, which cannot be operated for a second time, such as recurrent brain metastases, chemotherapy combined with intracranial radiotherapy can be considered; in case of intrapleural recurrence, most of them have no chance to operate again. 7.Can we still use minimally invasive surgery for the second surgery after lung cancer recurrence? In the past, when lung cancer recurred, the adhesions caused by the first surgery and the change of hilar structure posed great challenges to the second surgery. However, with the improvement of minimally invasive lumpectomy technology in recent years, more than half of the patients can still consider minimally invasive surgery for the second surgery after recurrence. If the first surgery is performed by open-heart surgery, some patients can also adopt minimally invasive surgery, mainly because the adhesions near the incision are more serious, and most of them can be separated under thoracoscopy. Can lung cancer still be cured after recurrence? It depends on the form of recurrence. If it is local recurrence or limited recurrence, there is still a chance of cure through secondary surgery. If there is genetic mutation, we should strive for targeted therapy; if there is no genetic mutation, we should consider chemotherapy combined with immunotherapy, which can make some lung cancer patients with recurrence gradually transform into chronic disease. Nine, the choice of chemotherapy after lung cancer recurrence After lung cancer recurrence, if you have not received targeted therapy or chemotherapy before, you can decide whether to perform targeted therapy according to whether you have gene mutation or not, if you do not have gene mutation, you can consider chemotherapy combined with immunotherapy. If you have received chemotherapy or targeted therapy before, it depends on the length of time between the last treatment and the recurrence. If the last treatment is longer than 1 year from the recurrence, chemotherapy may be effective if the original regimen is used again; if the last treatment is shorter than 6 months from the recurrence, it means that the last chemotherapy drug may have been resistant, and the tumor already has potential growth during the last chemotherapy. growth, in this case, it is usually necessary to adjust the chemotherapy regimen and choose other drugs for treatment.