Back to Search
Start Over
Effectiveness of intensive clinical and radiological follow-up in patients with surgically resected NSCLC. Analysis of 2661 patients from the prospective MAGRIT trial
- Source :
- European Journal of Cancer. 125:94-103
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background: Limited evidence is available on effectiveness of clinicoradiological follow-up of early-stage NSCLC patients. MAGRIT was a phase III adjuvant RCT conducted in surgically resected stage IB-IIIA NSCLC patients, in which all participants had a prospectively defined intensive clinicoradiological follow-up. Methods: At patient-level data, we analyzed detection modality of disease recurrences and new primary lung cancer (i.e. detected by clinicoradiological scheduled exams versus by interim unscheduled exams), features associated with higher risk of locoregional and/or distant recurrence, and recurrence rates over time. Results: In the 2261 patients studied, there was a significant association between the type of recurrence and the modality of detection: 88.4% (95% CI, 84%–91%) of the locoregional recurrences and 93.2% (95% CI, 84%–99%) of the new primary lung cancers were detected by scheduled exams, whereas this was only 68.7% (95% CI, 65%–73%) for distant metastases (p < 0.001). Survival of patients with locoregional recurrence or new primary lung cancer detected by scheduled exams was significantly better as compared with those detected by unscheduled exams (HR 0.56, 95% CI 0.36–0.87; p = 0.01). Survival was similarly poor in patients with distant recurrences, both with scheduled and unscheduled detection (3-year survival after recurrence 22.0% and 21.8%, respectively). Recurrence rate was the highest in the first 18 months after surgery—with a peak between month 6 and 12—decreasing thereafter. The hazard of a second primary lung cancer was constant over time. Conclusion: Intensive follow-up is effective in detecting locoregional recurrences and second primary lung cancers, with impact on patients’ survival but did not influence the detection of distant recurrences.
- Subjects :
- Male
0301 basic medicine
Cancer Research
medicine.medical_specialty
Lung Neoplasms
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Carcinoma, Non-Small-Cell Lung
medicine
Humans
In patient
Prospective Studies
Limited evidence
Stage (cooking)
Lung cancer
NSCLC risk of recurrence over time
Lung
business.industry
Second primary cancer
Clinico-radiological follow-up effectivene
medicine.disease
Survival Analysis
Variables affecting risk of relapse
030104 developmental biology
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Radiological weapon
Female
Radiology
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 09598049
- Volume :
- 125
- Database :
- OpenAIRE
- Journal :
- European Journal of Cancer
- Accession number :
- edsair.doi.dedup.....e3a5d0cdcb4e0b88c7c59ea6a561bad9