Abstract
Surveillance imaging is recommended by many organizations following resection of stage I non-small cell lung cancer (NSCLC) to detect locoregional disease recurrence or metachronous second primary lung cancer (SPLC). Many of these guidelines are based on expert opinion and there is a paucity of high-quality evidence to demonstrate oncologic benefit or cost-effectiveness of surveillance. Current evidence suggests that surveillance with computed tomography (CT) scanning results in earlier diagnosis of asymptomatic recurrence and SPLC, increasing the frequency of secondary treatment interventions, but has not consistently demonstrated improvement in survival or cost effectiveness. We provide a weak recommendation in favor of annual CT surveillance following surgical excision of stage I NSCLC.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
American Cancer Society. Cancer prevalence: how many people have cancer? http://www.cancer.org/cancer/cancerbasics/cancer-prevalence. Updated 2017. Accessed Sep 2019.
SEER. https://seer.cancer.gov/archive/csr/1975_2015/results_merged/sect_15_lung_bronchus.pdf. Updated 2015. Accessed Sep 2019.
Howington JA, Chang AC, Balekian AA, Murthy SC. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):278S–e313S.
National Cancer Institute. Survivorship. http://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/cancer-treatment-and-survivorship-facts-and-figures-2019-2021.pdf. Updated 2019. Accessed Sep 2019.
Lou F, Huang J, Sima CS, Dycoco J, Rusch V, Bach PB. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance. J Thorac Cardiovasc Surg. 2013;145(1):75–82.
Crabtree TD, Puri V, Chen SB, Gierada DS, Bell JM, Broderick S, Krupnick AS, Kreisel D, Patterson GA, Meyers BF. Does the method of radiologic surveillance affect survival after resection of stage I non-small cell lung cancer? J Thorac Cardiovasc Surg. 2015;149(1):45–52. 53.e1-3.
Colt HG, Murgu SD, Korst RJ, Slatore CG, Unger M, Quadrelli S. Follow-up and surveillance of the patient with lung cancer after curative-intent therapy: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e437S–54S.
Calman L, Beaver K, Hind D, Lorigan P, Roberts C, Lloyd-Jones M. Survival benefits from follow-up of patients with lung cancer: a systematic review and meta-analysis. J Thorac Oncol. 2011;6(12):1993–2004.
Backhus LM, Farjah F, Liang CK, He H, Varghese TKJR, Au DH, Flum DR, Zeliadt SB. Imaging surveillance and survival for surgically resected non-small-cell lung cancer. J Surg Res. 2016;200(1):171–6.
McMurry TL, Stukenborg GJ, Kessler LG, Colditz GA, Wong ML, Francescatti AB, Jones DR, Schumacher JR, Greenberg CC, Chang GJ, Winchester DP, McKellar DP, Kozower BD. More frequent surveillance following lung cancer resection is not associated with improved survival: a nationally representative cohort study. Ann Surg. 2018;268(4):632–9.
Billè A, Ahmad U, Woo KM, Suzuki K, Adusumilli P, Huang J, Jones DR, Rizk NP. Detection of recurrence patterns after wedge resection for early stage lung cancer: rationale for radiologic follow-up. Ann Thorac Surg. 2016;102(4):1067–73.
Hanna WC, Paul NS, Darling GE, Moshonov H, Allison F, Waddell TK, Cypel M, de Perrot ME, Yasufuku K, Keshaviee S, Pierre AF. Minimal-dose computed tomography is superior to chest x-ray for the follow-up and treatment of patients with resected lung cancer. J Thorac Cardiovasc Surg. 2014;147:30–3.
Hamaji M, Matsuo Y, Chen-Yoshikawa TF, Mizowaki T, Date H. Surgery and stereotactic body radiotherapy for early stage non-small cell lung cancer: review of meta-analyses. J Thorac Dis. 2019;11(Suppl 13):S1646–52.
Lamont JP, Kakuda JT, Smith D, Wagman LD, Grannis FW. Systematic postoperative radiologic follow-up in patients with non-small cell lung cancer for detecting second primary lung cancer in stage IA. Arch Surg. 2002;137(8):935–8. Discussion 938–40.
Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, Gareen IF, Gatsonis C, Marcus PM, Sicks JD, Team NR. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409.
Kent MS, Korn P, Port JL, Lee PC, Altorki NK, Korst RJ. Cost effectiveness of chest computed tomography after lung cancer resection: a decision analysis model. Ann Thorac Surg. 2005;80(4):1215–22. Discussion 1222–3.
Vansteenkiste J, De Ruysscher D, Eberhardt WE, Lim E, Senan S, Felip E, Peters S, Group EGW. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(Suppl 6):vi89–98.
National Comprehensive Cancer Network. NSCLC (Version 7.2019). https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf. Accessed Sep 2019.
National Institute for Health and Care Excellence. Lung cancer: diagnosis and management [Version NG122]. https://www.nice.org.uk/guidance/ng122/chapter/Recommendations. Accessed Sep 2019.
Schneider BJ, Ismaila N, Aerts J, Chiles C, Daly ME, Detterbeck FC, Hearn JWD, Katz SI, Leighl NB, Levy B, Meyers B, Murgu S, Nekhlyudov L, Santos ES, Singh N, Tashbar J, Yankelevitz D, Altorki N. Lung cancer surveillance after definitive curative-intent therapy: ASCO Guideline. J Clin Oncol. 2020;38(7):753–66.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Sankary, S.T., Ferguson, M.K. (2020). Is Long-Term Surveillance Effective After Resection of Stage I Non-small Cell Lung Cancer?. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-47404-1_21
Download citation
DOI: https://doi.org/10.1007/978-3-030-47404-1_21
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-47403-4
Online ISBN: 978-3-030-47404-1
eBook Packages: MedicineMedicine (R0)