Follow-up CT of ‘no benefit’ in the 2 years after complete NSCLC resection
medwireNews: Follow-up computed tomography (CT) imaging does not provide a clear survival benefit for patients who undergo complete resection of stage I–III non-small-cell lung cancer, suggests research presented at the ESMO 2017 Congress in Madrid, Spain.
Presenting author Virginie Westeel, from the Centre Hospitalier Régional Universitaire, Hôpital Jean Minjoz in Besançon, France, showed data for 1775 patients who were followed-up for a median of 8.7 years. The IFCT-0302 investigators examined the impact of the recommended screening guidelines of regular examination and chest X-ray plus chest CT every 6–12 months for 2 years and then annually thereafter.
Doing CT scans every 6 months for the first 2 years has provided no value, however, yearly CT scans might benefit patients over the long term.
Overall survival (OS) was a median of 123.6 months for the patients who underwent clinical examination and chest X-ray at 6-month intervals. This did not differ significantly from the 99.7 months for the patients who underwent clinical examination and chest X-ray, as well as thoraco-abdominal CT imaging alone or alongside bronchoscopy every 6 months.
However, exploratory analysis indicated that while median OS was comparable between the imaging arms for the patients who experienced relapse within 2 years (48.3 vs 48.4 months), median OS did significantly differ for patients who were free from recurrence at this time point, at a median value of 129.3 months for those given minimal follow-up, whereas the median was unreached for those who also underwent CT.
“Both follow-up protocols are acceptable”, Westeel told delegates but she believes that 6-monthly CT is “probably not useful during the first 2 years.”
Noting the high risk for secondary primary NSCLC in this patient population, the author believes there may be potential benefit for an annual screening CT thereafter.
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