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Follow-up and Surveillance of the Lung Cancer Patient Following Curative-Intent Therapy*

Gene L. Colice, MD, FCCP; Jeffrey Rubins, MD, FCCP; Michael Unger, MD, FCCP
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*From Critical Care and Respiratory Services (Dr. Colice), Washington Hospital Center, Washington, DC; Pulmonary Division (Dr. Rubins), Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; and Pulmonary Cancer Detection and Prevention Program (Dr. Unger), Fox Chase Cancer Center, Philadelphia, PA.

Correspondence to: Gene L. Colice, MD, FCCP, Washington Hospital Center, 110 Irving St NW, Washington, DC 20010; e-mail: gxc@mhg.edu



Chest. 2003;123(1_suppl):272S-283S. doi:10.1378/chest.123.1_suppl.272S
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The following two distinctly different issues should be taken into account when planning patient care following curative-intent therapy for lung cancer: adequate follow-up to manage complications related to the curative-intent therapy; and surveillance to detect recurrences of the primary lung cancer and/or development of a new primary lung cancer early enough to allow potentially curative retreatment. Follow-up for complications should be performed by the specialist responsible for the curative-intent therapy and should last 3 to 6 months. Recurrences of the original lung cancer will be more likely during the first 2 years after curative-intent therapy, but there will be an increased lifelong risk of approximately 1 to 2% per year of developing a metachronous, or new primary, lung cancer. A standard surveillance program for these patients is recommended based on periodic visits, with chest-imaging studies and counseling patients on symptom recognition. Whether subgroups of patients with a higher risk of developing a metachronous lung cancer (eg, those patients whose primary lung cancer was radiographically occult or central and those patients surviving for > 2 years after treatment for small cell lung cancer) should have a more intensive surveillance program is presently unclear. The surveillance program should be coordinated by a multidisciplinary tumor board and overseen by the physician who diagnosed and initiated therapy for the original lung cancer. Smoking cessation is recommended for all patients following curative-intent therapy for lung cancer.


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