Patients with early-stage disease represent approximately 20%�C30% of all patients with non-small cell lung cancer. Currently, surgery is the preferred treatment for early-stage NSCLC, and it is considered the only procedure with the potential to cure this condition. However, the long-term survival of patients with early-stage NSCLC is still not optimistic. Despite surgical resection, approximately 20�C40% of these patients die from local recurrence or distant metastasis within 5 years. The present study is the first to demonstrate the presence of a double-peaked recurrence hazard Acetylleucine pattern among early-stage non-small cell lung cancer patients after surgery. Our outcome of a double-peaked recurrence hazard pattern provides support for the theory of tumor dormancy, which postulates that micrometastatic foci may exist in different biologic steady states, most of which do not promote tumor growth. However, this orderly and stable process may be perturbed by surgery, which stimulates a transition from dormancy to growth, resulting in a sudden acceleration of the metastatic process and eventually leading to recurrence. This phenomenon may account for the first peak of recurrence risk of malignant Cefpiramide sodium carcinoma after surgery. The site of recurrence of early-stage NSCLC after surgical resection was also investigated in this study. Among patients with early-stage NSCLC, most tumors recurred as distant metastases, rather than local-regional recurrences. In early-stage NSCLC after surgical resection, the rate of distant metastasis has been reported to be between 14.0% and 23.0%, and the local-regional recurrence was 5.0%. The patterns of tumor recurrence affect the therapy and survival of NSCLC patients. Based on the present study, the adjuvant treatment for early-stage NSCLC should be systemic therapy, rather than local therapy, due to the recurrence pattern of this disease. High-risk factors, include poorly differentiated tumors, vascular invasion, wedge resection, tumors.4.0 cm, visceral pleural involvement, and incomplete lymph node sampling, are prognostic factors strongly associated with increased risks of recurrence and death among early-stage NSCLC patients.