Some studies had reported that identification the driver gene mutation can select patients with Fenticonazole Nitrate early-stage disease who are at high risk of recurrence. Brock et al. also confirmed that methylation of the promoter region of the cyclin-dependent kinase inhibitor 2A gene p16, the H-cadherin gene CDH13, the Ras association domain family 1 gene RASSF1A, and the Balsalazide adenomatous polyposis coli gene APC in patients with stage I NSCLC treated with curative intent by means of surgery is associated with early recurrence. Previous study reported that about 5.0% non small cell lung cancer have the risk of developing metachronous second primary lung cancer. The standard diagnosis of second primary lung cancer was controversial, the different histological type from that of the first tumor was considered as the key criteria to define the second lung cancer. In our study, the initial data showed about 3.54% patients developed second malignant tumor during the flow-up after surgical resection: 10 patients developed second primary lung cancer, and 29 patients developed the other site malignant tumor. All these patients were diagnosed as secondary malignant tumor in histological type and were excluded from the present study. However, for patients with multiple tumors after surgical resection, our study was limited to distinguish the second malignant tumor from metastatic disease. As a retrospective study, this study has other several potential limitations. The median follow-up time of 6.1 years was not sufficiently long; 576 patients were still alive at the last follow-up. Because there were only 147 patients who received platinumbased adjuvant chemotherapy, the subgroup analysis was unable to identify patients who might benefit from adjuvant chemotherapy. In conclusion, we confirmed the validity of a double-peaked pattern of recurrence risk of early-stage nonsmall cell lung cancer. The main pattern of tumor recurrence was distant metastasis, rather than local-regional recurrence.The hazard function may be useful for selecting patients at high risk of recurrence to receive postoperative therapy, which offers the possibility of decreasing and/or delaying the recurrence hazard.