Genomic alterations as independent prognostic factors to predict the type of lung cancer recurrence

•We analyzed genomics in locally (LR) versus distantly recurring (DR) LC patients.•DMXL2 and ABCC9 gene mutations were exclusively seen in the DR group.•Genes detected were responsible of Ca + channel transport in the DR group.•Genes detected were responsible of microtubule disturbance in the DR group.•Distinct genomic signatures in the LR and DR cohorts need further analysis. 33–70% of lung cancer (LC) patients develop recurrence after radical treatment. Previous studies have shown the importance of clinical-pathological characteristics for the risk of recurrence. The role of molecular mechanisms remains unclear. The aim was analyzing genomic features in LC patients with local (LR) versus distant recurrence (DR) to predict the risk and type of recurrence. Patients previously curatively treated with LC recurrences from 2015 to 2017 were retrospectively enrolled. Histological specimens collected at the time of LC diagnosis were sent for whole exome sequencing (WES). Genomic data was analyzed for single nucleotide polymorphisms (SNPs) and insertion-deletion mutations (INDELs). 191 patients were included. 33% of patients had LR and 67% DR, with median recurrence-free survival (RFS) 15.4 versus 11.2 months (p = 0.20) and overall survival (OS) after recurrence 12.9 versus 8.5 months (p = 0.007), respectively. Of various laboratory parameters studied, lymphocytes were significantly decreased at recurrence (p