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ESMO 2017: Are Follow-up CT Scans Necessary After Surgery for Non–Small Cell Lung Cancer?

By: Cordi Craig
Posted: Wednesday, September 13, 2017

Follow-up guidelines for patients with completely resected non–small cell lung cancer (NSCLC) suggest regular postoperative computed tomography (CT) scans every 3 to 6 months. However, a new study by Virginie Westeel, MD, PhD, of the Centre Hospitalier Régional Universitaire, Hôpital Jean Minjoz, Besançon, France, suggests they may not be necessary. The results of the IFCT-0302 trial, which were presented at the 2017 European Society for Medical Oncology (ESMO) Congress (Abstract 1273O), did not show significant differences in overall survival between patients who received CT scans in follow-up and those who did not.

“A conservative point of view would be to do a yearly CT scan, which might be of interest over the long term,” commented Dr. Westeel in an ESMO press release. “However, doing regular scans every 6 months may be of no value in the first 2 postoperative years.”

In the randomized trial, 2 follow-up programs for 1775 patients with completely resected stages I, II, or IIIA NSCLC were compared: arm 1 consisted of clinical examination and chest x-ray (n=888), and arm 2 consisted of a thoracoabdominal CT scan plus bronchoscopy in addition to the procedure for arm 1 (n=887).

After a median follow-up of nearly 9 years, the median overall survival for arm 1 versus arm 2 was 8.2 years and 10.3 years, respectively. Three-year rates of disease-free survival were not significantly different between arm 1 and arm 2 (63.3% vs. 60.2%), and 8-year overall survival rates showed similar results (51.1% vs. 55.6%).