Abstract 947P
Background
A significant portion of patients operated on for non-small cell lung cancer (NSCLC) will relapse eventually. There is currently no consensus regarding the best program for postoperative follow-up and surveillance after a curative resection of NSCLC patients. The objective of this study was to analyse the diagnostic capability of the diagnostic tests performed in our centre during the follow-up of patients with non-small cell lung cancer after surgical resection.
Methods
Retrospective review of 392 patients with surgically resected stage I-IIIA NSCLC. Data were collected for all patients treated between January 1, 2010 and December 31, 2020. We analysed clinical data, and recollected clinical, laboratory and radiological exams during their follow-up, identifying those that were relevant in the diagnosis of tumour relapses. We compared the monitoring carried out with the ESMO recommendations.
Results
67.1% of patients were male, with a median age of 66.0, and the most reported histology was adenocarcinoma (60.5). Median follow-up was 48.5 months. The data related to the follow-up tests performed and their diagnostic capability, as well as the expected number of tests carried out following ESMO recommendations are shown in the table. According to ESMO recommendations, we estimated that 1847 clinical revisions (mean 4.70) and 1847 Body CT (mean 4.70) should have been carried out. Table: 947P
Main evaluations performed and diagnostic yield
| Routine | Non routine | ||||||||
| Total | Mean | Diagnostic of relapse | % | Total | Mean | Diagnostic of relapse | % | ||
| Stage I | Clinical revision | 1029 | 5.33 | 2 | 0.19 | 15 | 0.08 | 15 | 100 |
| Body CT | 966 | 5.01 | 48 | 4.96 | 10 | 0.05 | 7 | 70 | |
| Stage II | Clinical revision | 473 | 5.44 | 3 | 0.63 | 7 | 0.08 | 7 | 100 |
| Body CT | 457 | 5.25 | 32 | 7 | 3 | 0.03 | 2 | 66.6 | |
| Stage IIIA | Clinical revision | 502 | 4.48 | 7 | 1.39 | 23 | 0.21 | 23 | 100 |
| Body CT | 482 | 4.30 | 48 | 9.96 | 13 | 0.05 | 9 | 69.2 | |
| Stages I-IIIA | Clinical revision | 2004 | 5.10 | 12 | 0.59 | - | |||
| Body CT | 1905 | 4.90 | 128 | 6.72 |
Conclusions
The vast majority of routine follow-up evaluations performed were not relevant for the management and only the body CT exceeded the threshold of 5% profitability, but without reaching 10% even in the highest stage. Profitability increased when they were carried out in a non-routine follow-up evaluation. The number of tests performed is similar to that expected following ESMO recommendations, which reinforces the clinical validity of the results. New follow-up strategies based on scientific evidence must be defined to improve the profitability of the tests performed.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.