Early post-operative CT-scan (ECT) for the postsurgical follow up of Non small cell lung cancer (NSCLC)

Background/Objectives: Early post-operative CT (ECT) scan after lung resection for NSCLC has been recently proposed in order to acquire the post surgical morphology of the chest for comparison during follow up. Theoretically it improves the differential diagnosis between fibrotic repair and recurrence. We adopted ECT in the period 1996-2001. Aim of this study is to report our experience. Materials & Methods: ECT scan within 90 days after radical surgery was performed in 98 patients (study group SG). We compared SG with a control group (CG) composed of 321 patients operated upon before 1996. Follow up modalities were the same in both groups. Results: Median follow up was 58 months (r 1-145) for CG and 21.6 months (r 1-74) for SG. Relapse of disease was found in 96(30%) patients of CG (50 local recurrences, 27 distant, 7 local and distant, 12 second primaries) and in 30(31%) patients of SG (21 local, 5 distant, 4 local and distant); disease free period for local recurrence was 47 months (r 5-107) for CG and 9.8 months (r 1-38) for SG (p<0.05). The three years survival after the diagnosis of local recurrence was 45% for SG and 10% for CG (p=0.05). The survival in patients with local recurrence three years after the first operation was 60% for SG and 65% for CG (p=0.302). Conclusions/Uploads: Follow up of NSCLC patients is controversial because of the costs in relation to the scanty efficacy of treatment of relapses. ECT is CHEAP. It diagnoses recurrence earlier with respect to the 12 months CT scan and followings. The longer survival after diagnosis of relapse is due to the lead time bias. ECT may be a useful tool for prospective studies on new treatments for local recurrence. Disclosure: All authors have declared no conflicts of interest.