Relevance of an intensive postoperative follow-up after surgery for non–small cell lung cancer
| Autor: | Didier Choma, Jean-François Pugin, François Clement, Virginie Westeel, Marie-Christine Woronoff-Lemsi, André Dubiez, Alain Depierre |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Physical examination Asymptomatic Pneumonectomy Carcinoma Non-Small-Cell Lung Intensive care medicine Humans Stage (cooking) Prospective cohort study Lung cancer Survival rate Aged Neoplasm Staging medicine.diagnostic_test business.industry Middle Aged medicine.disease Surgery Survival Rate Female Neoplasm Recurrence Local medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 70:1185-1190 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(00)01731-8 |
| Popis: | Background . Although a minimal follow-up with periodic clinic visits and chest radiographs is usually recommended after complete operation for non–small cell lung cancer, the ideal follow-up has not been defined yet. Objectives of this prospective study were to determine the feasibility of an intensive surveillance program and to analyze its influence on patient survival. Methods . Follow-up consisted of physical examination and chest roentgenogram every 3 months and fiberoptic bronchoscopy and thoracic computed tomographic scan with sections of the liver and adrenal glands every 6 months. Influence of patient and recurrence characteristics on survival from recurrence was successively analyzed using the log-rank test and a Cox model adjusted for treatment. Results . Among the 192 eligible patients, recurrence developed in 136 patients (71%) and was asymptomatic in 36 patients (26%). In 35 patients, recurrence was asymptomatic and detected by a scheduled procedure: thoracic computed tomographic scan in 10 (28%) patients and fiberoptic bronchoscopy in 10. Fifteen patients (43%) had a thoracic recurrence treated with curative intent. From the date of recurrence, 3-year survival was 13% in all patients and 31% in asymptomatic patients whose recurrence was detected by a scheduled procedure. Asymptomatic recurrences ( p p p = 0.01), and age 61 years or younger ( p = 0.01) were shown to be significantly favorable prognostic factors. Conclusions . This intensive follow-up is feasible and may improve survival by detecting recurrences after surgery for non–small cell lung cancer at an asymptomatic stage. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|