Impact of Surveillance after Lobectomy for Lung Cancer on Disease Detection and Survival

Abstract Introduction /Background: Existing guidelines for surveillance after non-small cell lung cancer (NSCLC) treatment are inconsistent and have relatively sparse supporting literature. This study characterizes detection rates of metachronous and recurrent disease during surveillance with computed tomography scans after definitive treatment of early stage NSCLC. Materials and Methods The incidence of metachronous and recurrent disease in patients who previously underwent complete resection via lobectomy for stage IA non-small cell lung cancer at a single center from 1996 to 2010 were evaluated. A subgroup analysis was used to compare survival of patients whose initial surveillance scan was 6±3 months (early) versus 12±3 months (late) after lobectomy. Results Of 294 eligible patients, 49 (17%) developed recurrent disease (14 local only, 35 distant) and 45 (15%) developed new NSCLC. Recurrent disease was found at a mean of 22±19 months and new primaries were found at a mean of 52±31 months after lobectomy (p Conclusion Surveillance after lobectomy for stage IA NSCLC is useful for identifying both new primary as well as recurrent disease, but waiting to start surveillance until 12±3 months after surgery is unlikely to miss clinically important findings.