Details

Autor(en) / Beteiligte

• Lou, Feiran, MD, MS
• Huang, James, MD, MS
• Sima, Camelia S., MD, MS
• Dycoco, Joseph, BA
• Rusch, Valerie, MD
• Bach, Peter B., MD, MAPP

Titel

Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2013, Vol.145 (1), p.75-82

Ort / Verlag

United States: Mosby, Inc

Erscheinungsjahr

2013

Quelle

ScienceDirect

Beschreibungen/Notizen

• Objective At present, there is no consensus on the optimal strategy for follow-up care after curative resection for lung cancer. We sought to understand the patterns of recurrence and second primary lung cancer, and their mode of detection, after resection for early-stage non–small cell lung cancer in patients who were followed by routine surveillance computed tomography scan. Methods We reviewed the outcomes of consecutive patients who underwent resection for early-stage non–small cell lung cancer at Memorial Sloan-Kettering Cancer Center between 2004 and 2009. Results A total of 1294 consecutive patients with early-stage non–small cell lung cancer underwent resection. The median length of follow-up was 35 months. Recurrence was diagnosed in 257 patients (20%), and second primary lung cancer was diagnosed in 91 patients (7%). The majority of new primary cancers (85 [93%]) were identified by scheduled routine computed tomography scan, as were a smaller majority of recurrences (157 [61%]). During the first 4 years after surgery, the risk of recurrence ranged from 6% to 10% per person-year but decreased thereafter to 2%. Conversely, the risk of second primary lung cancer ranged from 3% to 6% per person-year and did not diminish over time. Additional testing after false-positive surveillance computed tomography scan results was performed for 329 patients (25%), but only 4 of these patients (0.3%) experienced complications as a result of subsequent invasive diagnostic procedures. Conclusions Almost all second primary cancers and the majority of recurrences were detected by post-therapeutic surveillance computed tomography scan. The risk of recurrence for early-stage non–small cell lung cancer survivors persisted during the first 4 years after resection, and vigilance in surveillance should be maintained.