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Ann Thorac Surg 1995;60:1570-1572
© 1995 The Society of Thoracic Surgeons

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Discussion

Discussion

The first 300 words of the full text of this article appear below.

See also page 1563.

DR DAVID J. SUGARBAKER (Boston, MA): I have a couple of questions. It is clear that recurrence after primary surgical therapy for lung cancer is a very difficult clinical situation and rarely results in any long-term cure or long-term survival in that cohort of patients who have recurrence in the short time period of your study. I think the main reason that most of us follow up patients who have had primary resection for lung cancer, however, is based on the data from several institutions that suggest that 2% to 3% per year will have development of a new primary lesion. One of the reasons why your study, I think, may not have shown the clear benefit of follow-up for those patients is because you looked at a group of patients who had resection over a 5-year period. You would predict that your survivors would assume a 30% to 40% chance as they get beyond 10 years in their follow-up. So I think it would be wrong to conclude from your study that patients who have had primary resection for lung cancer should not be closely followed up with a plain chest roentgenogram, which in your study I think was nicely demonstrated to be probably the most sensitive and practical way to follow up these patients.

Can you comment on the role of follow-up for patients in detecting new primary lesions as opposed to detecting untreatable recurrent disease?

DR WALSH: Our review attempted to answer the question, ``Does patient follow-up affect the natural history of a patient's primary lung cancer?'' You have asked a separate and equally complex health care question, ``Should we regularly follow up and screen asymptomatic patients after resection of lung cancer for second primary bronchogenic tumors or other aerodigestive malignancies? If so . . . [Full Text of this Article]

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Is Follow-up of Lung Cancer Patients After Resection Medically Indicated and Cost-Effective?

Garrett L. Walsh, Maeve O'Connor, Kelly M. Willis, Mira Milas, Rose S. Wong, Jonathan C. Nesbitt, Joe B. Putnam, Jr, J. Jack Lee, and Jack A. Roth
Ann. Thorac. Surg. 1995 60: 1563-1570. [Abstract] [Full Text]

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