Author of

• 12701

  +

  P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12723

    +

    P3.12-022 - Patterns of disease recurrence and modality of detection following surgery for early stage lung cancer (ID 3413)

    09:30 - 09:30  |  Author(s): D. Mukherjee
    • Abstract

    Background
    There is a significant risk of disease recurrence following surgery with curative intent for non-small cell lung cancer (NSCLC). However, limited data is available on the patterns of recurrence and best practice for follow up imaging after lung cancer surgery. Current practice in the United Kingdom (UK) is to perform interval chest x-ray for 5 year following surgery. We aimed to determine the incidence, anatomical site, modality of detection and percentage of patient requiring acute admission as a harbinger of disease recurrence post thoracotomy for NSCLC

    Methods
    Records of consecutive patients with NSCLC who underwent thoracotomy and resection of early stage lung cancer at 5 institutions situated in the South East of the UK between October 2007 and September 2012 were interrogated. Data collection was completed in Jan 2013.

    Results
    A total of 314 patients were included; 59 (18.8%) patients died from disease recurrence during the study period, the site of recurrence was lung, central nervous system, bone/ soft tissue, abdominal and lymph node respectively in 24 (40.7%), 17 (28.8%), 10 (16.9%), 4 (6.8%) and 4 (6.8%) cases. In 45 (76.2%) patients disease recurrence was detected during outpatient consultation, modality of detection for routine chest x-ray, CT and other modalities were respectively 7 (15.5% ), 28 (62.2%) and 10 (22.3%) in every case CT was prompted by change in symptoms, a clinically palpable mass lesion or clinical suspicion. Other modalities used were MRI, ultrasound and lymph node aspiration in 4, 3 and 3 cases respectively. Emergency admission accounted for 14 (23.8%) patients pathway to detection of recurrence, of these 9 (64.3%) were admitted with symptoms relating to cerebral metastases, 4 (28.6%) with symptomatic breathlessness and 1 (7.1%) with a pathological fracture.

    Conclusion
    Almost a quarter of patients with relapsed lung cancer following surgery present with acute symptoms requiring emergency admission. Standard chest x-ray follow-up detects very few recurrences with most cases being detected once reported symptoms direct further investigation. It is currently unknown whether earlier detection of recurrence may offer symptomatic or survival gains however avoidance of emergency admissions is likely to have a positive impact on quality of life. Further studies to investigate which patients are at highest risk of recurrence and the most appropriate post-surgical follow-up strategies are required.