Follow-up of patients after resection for bronchogenic carcinoma

To investigate how the members of the European Association for Cardio-Thoracic Surgery (EACTS) follow up their patients after pulmonary resection for bronchogenic carcinoma.

A questionnaire was sent to 317 EACTS members (thoracic and cardiothoracic surgeons as well as surgeons of unknown field of clinical practice). We eventually received completed questionnaires from 101 (31.9%) surgeons, who were classified into "thoracic" and "others". Their answers were analysed by the chi-square test.

One out of four EACTS members does not follow up his/her patients, while the remainder follow them up with or without the collaboration of a clinical oncologist, a pneumonologist or a family physician. Among the surgeons who follow up their patients, only one out of two does so throughout the patient's remaining life. The frequency of the routine follow-up visits as well as the type and frequency of the examinations used vary significantly among the members of the Association, but generally the frequency of visits tends to decrease with time. Although 89.8% of surgeons believe that a well scheduled follow-up is beneficial to the patient, only 67% think that such a follow-up is cost-effective.

A great diversity was observed in the way patients operated on for lung cancer are followed up by the EACTS members. The differences were more evident between "thoracic" and "other" surgeons. However, hard data showing the effect of these differences on patients' long-term survival are not available and prospective cooperative studies on this subject are required. Taking into account that these patients are, for the rest of their lives, at high risk of development of a metachronous primary bronchogenic carcinoma or other potentially curable malignancies, we believe that a life-long follow-up is mandatory.