Original articles: General thoracicWho should follow up lung cancer patients after operation?
Section snippets
Patients and methods
The Kingston General Hospital database was searched to identify patients treated surgically for a pulmonary neoplasm between January 1, 1988, and December 31, 1995. The following exclusion criteria were applied: (1) malignancy other than NSCLC stage IA to IIB, (2) history of previous pulmonary malignancy, (3) synchronous lung cancer primaries, (4) inability to withstand pulmonary resection, (5) use of adjuvant therapy (eg, radiation, chemotherapy), and (6) death within 30 days of operation.
The
Results
The study group included 245 surgically treated stage IA to IIB NSCLC patients. A total of 344 patients were scheduled for surgical treatment of an NSCLC between 1988 and 1995. Patients with stage III to IV NSCLC tumors were excluded. Of the remaining 268 patients, 8 died within 30 days of operation (3.2%), 6 could not tolerate pulmonary resection at the time of thoracotomy, 5 received adjuvant radiation therapy, 3 had a positive history of pulmonary neoplasm, and 1 patient had synchronous
Comment
Arguments in favor of routine surveillance of postoperative lung cancer patients include the potential for early detection of a recurrence or a new primary aerodigestive tract tumor 6, 7. Identification and treatment of potential complications of the operation, along with maintenance of a good surgeon–patient relationship, are also part of the rationale for routine follow-up [4]. Such practice is ingrained in surgery residency training, and its justification is probably based more on surgical
Acknowledgements
Supported by E.J.P. Charrette Memorial Research Fund, Queen’s University, Canada.
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Cited by (53)
Results of the first Phase III Randomized Trial assessing Overall Survival in Lung Cancer Patients using a Web-application-mediated Follow-up compared to Standard Modality
2016, Bulletin de l'Academie Nationale de MedecineWhat is the most practical, optimal, and cost effective method for performing follow-up after lung cancer surgery, and by whom should it be done?
2013, Thoracic Surgery ClinicsCitation Excerpt :After that, there are no clear guidelines as to what should be the frequency of follow-up visits, although the National Comprehensive Cancer Network recommends monitoring, including a history and physical examination every 4 months for the first 2 years and every 6 months thereafter.18 The discrepancies in conclusions among some of the published series (Table 3)19–22 illustrate not only the problem of bias in the selection of patients included in the study (most studies are retrospective) and calculation of results, but also that of the nonstandardized terminologies used to define recurrences or second primaries. A meta analysis and systematic review of survival benefits from the follow-up of patients with previously resected lung cancer done by Calman and colleagues23 in 2011 showed no clear-cut benefit to intensive follow-up in 1669 patients with regards to survival (hazard ratio: 0.83; P = .13; confidence interval: 0.66–1.05).
Survival benefits from follow-up of patients with lung cancer: A systematic review and meta-analysis
2011, Journal of Thoracic OncologyComparative Survival in Patients With Postresection Recurrent Versus Newly Diagnosed Non-Small-Cell Lung Cancer Treated With Radiotherapy
2010, International Journal of Radiation Oncology Biology PhysicsCitation Excerpt :Although incremental advancements have been made in the early diagnosis and treatment of NSCLC, local recurrence remains a major problem in achieving cure. The reported recurrence rates after complete surgical resection range from 15.7% to 75% (2–5). It is clear that achieving cure and long-term survival depends on whether recurrence develops after complete surgical resection and the success of the subsequent therapy.