[Postoperative follow-up and surveillance for NSCLC patients]

The following two distinctly different issues should be taken into account when planning patient care following curative- intent therapy for non-small cell lung cancer(NSCLC): adequate follow-up to manage complications related to the curative-intent therapy; and surveillance to detect recurrences of the primary lung cancer and/or development of a new (second) primary lung cancer early enough to allow potentially curative retreatment. The appropriate protocol of postoperative surveillance for patients with NSCLC is still controversial. At the moment, a clinically reasonable surveillance approach would include a history, physical examination and an imaging study (either CXR or CT) every 6 months for 2 years and then annually. Recently, there is a wide diversity in the status of postoperative patients with NSCLC in Japan. For example, the incidence of bronchioloalveolar carcinoma which has a favorable prognosis, small-sized tumor, and elderly patients is increased in Japan. Furthermore, adjuvant chemotherapy has become a standard therapy for patients with pathologic stage I B, II A, II B, and III A around the world. At present, it is recommended that postoperative patients be followed based on the current recommended surveillance program with several alterations according to their physical and oncological status. An appropriate protocol of postoperative surveillance for patients with NSCLC should be immediately established.