Following resection of a T1N1 squamous cell cancer in a 47-year-old male, the following is/are true:

a. There is a higher risk of local recurrence than with any other histologic type of non-small cell cancer

b. The greatest risk to the patient is a distant metastasis

d. If the patient survives five years, there is a greater risk of a new lung cancer than recurrence

The risk of local recurrence for non-small cell carcinomas of the lung is much more common for those of squamous cell histology than the others and averages 20%–30% overall. The greatest risk, however is of distant metastases which occur in 70%–80% of patients, regardless of stage. Almost all recurrences are seen within five years, and of the distant metastatic sites, the brain is most commonly affected. In this patient with Stage II disease, radiation therapy would be a consideration to reduce the incidence of local recurrence, but not chemotherapy. After five years, the highest risk would be from a new lung cancer rather than a recurrence.