[Follow up of non small cell lung cancer. Should patients be followed up after surgery for non-small cell lung cancer and how?].
BACKGROUND
Survival of patients after surgery for non-small cell lung cancer is significantly impaired because of frequent fatal recurrences. Logically, follow-up should detect early recurrences, thus increasing chances of cure.


BACKGROUND
Only nonrandomized studies have been published. These data show that: thoracic recurrences are the most frequent and the most frequently treated with curative intent; diagnosis of recurrences while patients are still asymptomatic might improve survival. Several guidelines have been published, with follow-up programs of variable intensity and with a recent tendency to reduce follow-up procedures to the only clinical visit with medical history and physical examination (American Society of Clinical Oncology, 2004).


CONCLUSIONS
All these recommendations consider that there is a need for randomized data. Only one randomized trial is ongoing, conducted by the Intergroupe Francophone de Cancérologie Thoracique (IFCT). This study compares a minimal follow-up with physical examination and chest X-ray and a more intensive follow-up program reflecting the French everyday practice including physical examination, chest X-ray, thoracic CT scan and fiberoptic bronchoscopy.


CONCLUSIONS
Follow-up might be interesting for patients operated on for a NSCLC. Its modality remain to be defined. As it is not possible to define the optimal follow-up after surgery for non-small cell lung cancer from existing data, the IFCT randomized study represents for pulmonologists, oncologists and thoracic surgeons a good opportunity to rationalize postoperative follow-up.
Westeel
V
V
Service de Pneumologie, CHU Hôpital Jean Minjoz, Besançon, France. virginie.westeel@ufc-chu.univ-fcomte.fr
D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*