番茄社区

AMSTERDAM -- Lung cancer patients who underwent surgical resection and whose management plans included follow-up computer tomography (CT) chest scans had higher subsequent survival rates compared with patients whose plans lacked the post-operative CT imaging, new study findings show.

Although it is widely accepted that a CT-based follow-up plan after lung cancer surgery can lead to earlier detection of a cancer recurrence, the study investigators asserted that these new data, first presented here at the International Congress, are the first to demonstrate that follow-up CT scans may contribute to patients' overall chances of survival.

"Our results show a significant improvement for survival rates for patients post-surgery in a CT follow-up program," , the study's presenting author and a pulmonologist at in Denmark, wrote in a statement. "A key strength of our study is the real-life setting we used, where we were able to demonstrate successful results in a representative sample of lung cancer patients from Denmark. This is very encouraging news and we believe that our results could contribute to the planning of similar treatment programs in other centers and countries."

Hansen and colleagues, based at Odense University Hospital, followed 391 patients who were diagnosed with lung cancer between 2008 and 2013 and ultimately underwent curative-intent surgery as a result. Beginning in July 2010, patients received CT scans of the thorax and upper abdomen every third month for 2 years and then every 6 months for 3 years afterward.

A total of 158, or 16%, of patients in the study received treatment in the 2.5 years before hospital officials implemented the CT-based follow-up protocol, while 233, or 15.3%, of patients underwent post-surgery treatment in the 3.5 years after the implementation.

If cancer recurs after surgery, it typically does so in the first 2 or 3 years after treatments are completed. A CT scan of the chest covers the areas of the body -- the adrenal glands and liver, along with the lungs -- where recurrence is most likely to arise following lung cancer surgery.

The researchers found a significant difference between survival curves of patients who received post-surgery treatment before and after the introduction of the CT-based follow-up program, with an observed 4-year survival rate of 55.7% for those treated without CT-based follow-up, compared with an estimated 4-year survival rate of 67.8% for those receiving follow-up CT scans (95% CI 60.4-75.2, P=0.046 log rank test).

After further statistical investigations relating to patient gender, age

, pulmonary function testing, ECOG performance status, Charlson comorbidity index scores, disease stage, tumor size, and type of surgery, plus a Cox regression analysis, the research team established a hazard ratio of 0.69 (P=0.046) for survival among patients treated without CT-based follow-up versus those treated with the follow-up scans.

According to Hansen, the research team now is planning a similar study for patients who were treated with radiation, as opposed to surgery.

Study limitations included its single-center, retrospective design, which meant that the possibility of unmeasured confounders could not be ruled out.

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