P1.08-014 Usefulness of Chest CT in Follow-Up of Patients with Completely Resected Lung Cancer

Abstract

There is no consensus about the best method to follow up patients after complete resection of lung cancer. This study was performed to identify how often follow-up chest-CT detected recurrence or a second primary lung cancer in asymptomatic patients. This is a retrospective study. Patients with diagnosis of non-small cell lung cancer submitted to complete surgical resection were included. They were followed-up with regular visits to the clinic and chest CTs. The visits to the clinic were every three months in the first two years, semiannually up to the fifth year, and annually thereafter. Patients were classified in symptomatic and asymptomatic according to the presence of clinical manifestations at each visit. From 2003 to 2013, 134 patients were included. Median age was 63.5 years. Seventy three (54.5%) were male. Current or former-smokers were 70.1% of the patients. Adenocarcinoma was the most common histologic type, observed in 82 (61.2%) of the patients. Lobectomy/bilobectomy was performed in 99 (73.8%), segmentectomy in 31 (23.1%), and pneumonectomy in 4 (3%). Pathological stage was: IA(53%), IB(10.2%), IIA(11.7%), IIB(6,6%), IIIA(13.3%), IIIB(3.1%), and IV (2.1%). Forty six (44.3%) patients were submitted to adjuvant treatment. Median follow-up was 30.2 months. Recurrence was detected in 18 (13.4%) patients, being local (including mediastinal) in 10 (7.4%), and distant in 8 (5.9%). Local recurrences were mainly detected by chest CT in asymptomatic patients. Distant recurrence was detected mostly by clinical symptoms (Table 1). Second primary lung cancers were found by chest CT in 15 (11.2%) asymptomatic patients.Table 1Correlation between type of recurrence and presence of symptoms.Local recurrenceDistant recurrenceCT (Asymptomatic)9 (90%)2 (25%)CT (Symptomatic)1 (10%)6 (75%)Total10 (100%)8 (100%) Open table in a new tab p = 0.09. Routine chest-CT detected most cases of local recurrence and second primary lung cancers in asymptomatic patients after curative resection of non-small cell lung cancer. Clinical examination and chest CT should be recommended for follow up after complete surgical resection.