[Follow-up of patients with non-small-cell pulmonary cancer undergoing complete resection. Should surgeons be in charge?]

To evaluate the effectiveness of patient follow-up after complete lung resection for non-small cell carcinoma in the same unit where the patients were treated. Retrospective review of outpatient clinic records of patients undergoing surgery for lung cancer between January 1994 and December 1996 who met the following conditions: histologically complete resection (segmentary and wedge resections were excluded) and survival at least three months after surgery. Follow-up was in accordance with preestablished guidelines that included taking the patient's medical history and performing physical examination, simple chest X-ray, hematocrit and biochemical parameters, chest and abdominal computerized tomography (CT) and periodic bronchoscopy. In 103 cases followed for between three to 34 months, 27 recurrences were detected (13 remote, 11 local and 3 local and remote). The clinical diagnosis of recurrence was made by case history adn physical examination in 18 cases, by simple chest film in 3, by biochemical blood parameters in 2, by fiber optic bronchoscopy in 2, and by CT findings in 2. One of the patients with local recurrence (bronchial stump) underwent a second operation 11 months after the first. Most recurrences are detected during simple checkups that can be performed without hospital admission. Only one patient underwent surgery for a local recurrence, suggesting that follow-up by thoracic surgery units does not appear to be worthwhile.