PURPOSE: Only 30 to 50% of patients survive for more than 5 years after lung cancer operation. Strict follow-up after operation is routine in most hospital, but most patients die of systemic metastases. We studied to know if a strict follow-up after operation is mandatory.
METHODS: We retrospectively evaluated 365 patients who underwent complete resection of non-small cell lung cancer in one tertiary referral center during 10 years and complete follow-up for at least 1 year. We separated lung cancer patients as two groups according to the existence of the symptom at the time of diagnosis of recurrent cancer, and evaluated whether the treatment modality was different between two groups.
RESULTS: The recurrences of the lung cancer were detected in 106 patients, at routine follow-up without symptom in 37 patients (F group), and at visit for the symptoms in 69 patients (S group). In F and S group, the numbers of patients with intra- and extra-thoracic recurrence were 26(70.3%) and 11(29.7%); 30(43.5%) and 39(56.5%) respectively (p value = 0.014). But, the numbers of early stage (I, II) and advanced stage (III, IV) in F and S group were 22(59.5%) and 15(40.5%); 33(47.8%) and 36(52.2%), and not significantly different (p value = 0.310). The numbers according to the treatment modality in F and S group for operation, radiation, chemotherapy, others, and none were 0(0%), 3(8.1%), 19(51.4%). 0(0%), and 15(40.5%); 5(7.2%), 23(33.4%), 21(30.4%), 1(1.4%), and 20(29%), respectively. The number of the patients included in treated group was not different in F and S group (22/37(59.5%) vs. 50/69(72.5%), p value = 0.195).
CONCLUSION: Strict follow-up and early detection may not be helpful for the treatment of recurrent lung cancer.
CLINICAL IMPLICATIONS: The follow-up plan after surgical resection of lung cancer should be individualized according to the health status of patients and attitude for the future treatment.
DISCLOSURE: Choonhee Son, None.