Is More Frequent Surveillance Associated With Better Survival for Patients With NSCLC?
Posted: Wednesday, December 12, 2018
According to a study published in the Annals of Surgery, improved survival outcomes and more frequent surgical surveillance are not correlated in patients with non–small cell lung cancer (NSCLC). Benjamin D. Kozower, MD, MPH, of the Washington University School of Medicine, and colleagues sought to determine a connection between surveillance and survival after recognizing the absence of high-quality data on postoperative imaging and outcomes in this patient population.
“Lung cancer recurrence has a poor prognosis, so the idea that finding it early means a physician can successfully treat it does not hold true,” stated Dr. Kozower in an American College of Surgeons press release. “It will be very important for physicians to be honest with their patients, so they understand that more frequent surveillance will not benefit them.”
The study included a total of 4,463 patients with stages I, II, and III NSCLC, organized into groups based on the amount of time between surgery and initial surveillance by computed tomography scan: 3 months (n = 1,614), 6 months (n = 1,999), and 1 year (n = 850). Age, sex, histology, and other factors were similar among the groups.
In a regressive comparison of imaging data from the 3-month and 6-month group members who were living cancer-free 9 months after their surgeries, an increased frequency of surveillance did not increase the likelihood of overall survival. These groups had consistent rates of development of a new primary cancer (10.6%) and recurrence (28.9%). “More frequent surveillance was not associated with longer risk-adjusted overall survival (hazard ratio for 6 months = 1.16; annual = 1.06; P = .14),” the investigators reported. Researchers found that more recent surveillance before recurrence did not indicate increased odds of survival after recurrence. Patients who did not undergo imaging for more than 14 months were determined to be at no greater risk of death than those who underwent imaging more frequently.