title: A proposal of postoperative follow-up pathways for lung cancer.
abstract: OBJECTIVE
  Although follow-up surveillance after resection for lung cancer is commonly performed in clinical practice, there is no standard follow-up program. We attempted to establish follow-up examination schedules that we considered would be acceptable to the majority of doctors, and would like to propose them as standard postoperative follow-up pathways.
  
  
  METHODS
  We carried out a retrospective analysis of patients' data and reviewed the time of detection of recurrence and the site of recurrence after resection. Published papers were also reviewed. The postoperative follow-up pathways were established based on these data.
  The follow-up period was set at as 5 years after resection, and physical examinations, chest radiography, chest CT and blood examination are recommended. Two follow-up pathways were proposed taking the risk of recurrence into consideration: the Risk of recurrence-based pathway and the Comprehensive pathway. In the Risk of recurrence-based pathway, the follow-up examination schedule is modified according to the risk of recurrence. In the Comprehensive pathway, a single universal examination schedule is recommended for all patients. The choice between these two pathways is left to the discretion of the attending doctor.
  
  
  CONCLUSIONS
  We proposed two follow-up pathways, based on retrospective analysis of patients' data and a review of published papers, which we considered would be acceptable to the majority of doctors and would be suited to the current medical environment in Japan. A prospective study to evaluate the efficacy of the follow-up pathways is ongoing.
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-chou, Matsuyama, Ehime, 791-0280, Japan, ssawada@shikoku-cc.go.jp.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sawada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shiono
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tagawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sato
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Harada
authors.forename: Motohiro
authors.initials: M
authors.lastname: Yamashita
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D010808:Physical Examination; D011184:Postoperative Period; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012107:Research Design; D015996:Survival Rate / Q000639:trends