Author of

• 20125

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  OA 04 - Surgery from Minimal to Radical (ID 661)

  • Event: WCLC 2017
  • Type: Oral
  • Track: Surgery
  • Presentations: 1
  • Moderators:J. Lee, A. Chang
  • Coordinates: 10/16/2017, 15:45 - 17:30, Room 311 + 312

  • 23039

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    OA 04.06 - Surgeon Practices for Post Resection Lung Cancer Surveillance: Comparisons of STS and ESTS Members   (ID 8689)

    16:40 - 16:50  |  Author(s): N. Novoa
    • Abstract
    • Presentation
    • Slides

    Background:
    A 1995 survey of Society of Thoracic Surgeons (STS) members revealed widespread variation in post resection lung cancer surveillance practices as well as pessimism regarding any survival benefit. We sought to compare contemporary practice patterns and attitudes toward post-resection surveillance among members of STS and of European Society of Thoracic Surgeons (ESTS).
    
    Method:
    A survey identical to one conducted in 1995 was administered via mail or electronically to surgeon members of the STS and ESTS requesting response from those treating NSCLC. Demographic information, type, frequency and duration of post-resection testing were collected. Goodness of fit tests were used to compare profiles of respondents and attitudes toward testing between groups. Analyses were performed using SAS 9.4 (SAS Institute, Cary, NC).
    
    Result:
    Between 8/2016-10/2016, 2978 STS members (response rate 7.8%, n=234) and 1450 ESTS members (response rate 8.4%, n=122) were surveyed. ESTS and STS respondents were similar in their frequent use of history and physical examination (75% vs 78%, p=0.26) and CT chest (71% vs 73%, p=0.61) although the timing of testing was widely variable. Compared to STS members, ESTS members reported more frequent use of testing not recommended by guidelines (for asymptomatic patients) including CXR (46% vs 34%, p=0.02) bronchoscopy (10% vs 1% p<0.01), bone scan (5% vs 0, p<0.01), brain CT (6% vs 0, p<0.01), and brain MRI (3% vs 0%, p=0.01). Compared to STS members, ESTS surgeons were more likely to “agree” or “strongly agree” that routine testing for NSCLC recurrence results in potentially curative treatment (86% vs 70%, p<0.01). Similarly, ESTS respondents were more likely to believe surveillance would identify a curable second primary NSCLC (94% vs 84%, p<0.01). More ESTS than STS respondents believed that current literature documents definitive survival benefits from routine follow-up testing (57% vs 30%, p<0.01), a misconception reported by only 26% STS respondents in the identical 1995 survey.
    
    Conclusion:
    Our survey suggests significant differences between ESTS and STS members regarding the method, frequency and attitudes regarding post-resection surveillance for NSCLC. European surgeons report a more optimistic belief in significant survival benefit from early detection of both recurrent and second primary NSCLC thus adopting more aggressive surveillance practices. This is in spite of a lack of definitive evidence-based literature underscoring the need for both better prospective studies and joint recommendations to standardize practice.
    
    

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