Postoperative follow-up for patients with non-small cell lung cancer.
BACKGROUND
It is unclear whether postoperative follow-up by thoracic surgeons or chest physicians for non-small cell lung cancer (NSCLC) alters survival.


METHODS
The charts of 1,398 NSCLC patients, diagnosed between 1980 and 2008, were reviewed. Prognostic factors contained therein were evaluated using univariate and multivariate analyses. Patients were divided into 2 groups according to the doctor in charge of their postoperative follow-up: the thoracic surgeon group and the chest physician group. The doctors in charge of following up the patients were also analyzed for prognostic significance.


RESULTS
In the univariate and multivariate analyses, age 65 years or younger, female sex, early pathological stage, Charlson Index score of 0-1, absence of adjuvant therapy, and follow-up by a chest physician were significantly favorable prognostic factors. Examined overall, NSCLC patients in the chest physician group had longer survival than those in the thoracic surgeon group. The difference in survival of patients with advanced disease was also statistically significant between these 2 groups.


CONCLUSIONS
Our results indicate that early detection of asymptomatic disease by regular follow-up including chest computed tomography scan may improve the chance of treatment with curative intent and thus may increase survival, irrespective of the doctor in charge of follow-up.
Nakamura
Ryota
R
Division of Thoracic Cardiovascular Surgery, University of Tsukuba, Ibaraki, Japan.
Kurishima
Koichi
K
Kobayashi
Naohiro
N
Ishikawa
Shigemi
S
Goto
Yukinobu
Y
Sakai
Mitsuaki
M
Onizuka
Masataka
M
Ishikawa
Hiroichi
H
Satoh
Hiroaki
H
Hizawa
Nobuyuki
N
Sato
Yukio
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010348:Patient Care Team; D011379:Prognosis; D015272:Pulmonary Medicine; D015996:Survival Rate; D013903:Thoracic Surgery; D014057:Tomography, X-Ray Computed