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  1. Is follow-up of lung cancer patients after resection medically indicated and cost-effective ? Discussion.

    Article, Communication - En anglais

    Society of Thoracic Surgeons. Annual meeting. Palm Springs CA USA, 1995/01/30.

    Background

    There are no guidelines for the appropriate follow-up of patients after pulmonary resection for lung cancer.

    Methods

    Three-hundred fifty-eight consecutive patients who had undergone complete resections of non-small cell lung cancer between 1987 and 1991 were evaluated for tumor recurrence and development of second primary tumors.

    Recurrences were categorized by site (local or distant), mode of presentation (symptomatic or asymptomatic), treatment given (curative intent or palliative), and duration of overall survival.

    Results

    Recurrences developed in 135 patients (local only, 32 ; local and distant, 13 ; and distant only, 90).

    Of these, 102 were symptomatic and 33 were asymptomatic (most diagnosed by screening chest roentgenogram).

    Forty patients received treatment with curative intent (operation or radiation therapy>50 Gy) and 95 were treated palliatively.

    The median survival duration from time of recurrence was 8.0 months for symptomatic patients and 16.6 months for asymptomatic patients (p=0.008).

    Multivariate analysis shows that disease-free interval (greater than 12 months or less than or equal to 12 months) was the most important variable in predicting survival after recurrence and that mode of presentation, site of recurrence, initial stage, and histologic type did not significantly affect survival.

    New primary tumors developed in 35 patients

    Conclusions.

    Although detection of asymptomatic recurrences gives a lead time bias of 8 to 10...

    Mots-clés Pascal : Tumeur maligne, Bronchopulmonaire, Résection chirurgicale, Analyse coût efficacité, Economie santé, Etude longitudinale, Traitement, Survie, Homme, Appareil respiratoire pathologie, Poumon pathologie, Bronche pathologie, Chirurgie

    Mots-clés Pascal anglais : Malignant tumor, Bronchopulmonary, Surgical resection, Cost efficiency analysis, Health economy, Follow up study, Treatment, Survival, Human, Respiratory disease, Lung disease, Bronchus disease, Surgery

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    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0103375

    Code Inist : 002B25D. Création : 199608.