Follow-up and surveillance of the lung cancer patient following curative-intent therapy

Chest. 2003 Jan;123(1 Suppl):272S-283S. doi: 10.1378/chest.123.1_suppl.272s.

Abstract

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.

Publication types

  • Guideline
  • Practice Guideline
  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / therapy*
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / therapy*
  • Neoplasms, Second Primary / diagnosis*
  • Neoplasms, Second Primary / therapy*
  • Pneumonectomy / adverse effects
  • Radiotherapy / adverse effects
  • Smoking Cessation

Substances

  • Antineoplastic Agents