This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Rubins, J. Articles by Colice, G. L. Search for Related Content PubMed PubMed Citation Articles by Rubins, J. Articles by Colice, G. L.

Follow-up and Surveillance of the Lung Cancer Patient Following Curative Intent Therapy^*

ACCP Evidence-Based Clinical Practice Guideline (2nd Edition)

^* From the Pulmonary Division (Dr. Rubins), Minneapolis VA Medical Center, University of Minnesota, Minneapolis, MN; Pulmonary Cancer Detection and Prevention Program (Dr. Unger), Fox Chase Cancer Center, Philadelphia, PA; and Pulmonary, Critical Care and Respiratory Services (Dr. Colice), Washington Hospital Center, Washington, DC.

Correspondence to: Jeffrey B. Rubins, MD, Pulmonary 111N, One Veterans Dr, Minneapolis, MN 55417; e-mail: rubin004{at}umn.edu

Background: To develop an evidence-based approach to follow-up of patients after curative intent therapy for lung cancer.

Methods: Guidelines on lung cancer diagnosis and management published between 2002 and December 2005 were identified by a systematic review of the literature, and supplemental material appropriate to this topic was obtained by literature search of a computerized database (Medline) and review of the reference lists of relevant articles.

Results: Adequate follow-up by the specialist responsible for the curative intent therapy should be ensured to manage complications related to the curative intent therapy and should last at least 3 to 6 months. In addition, a surveillance program should be considered to detect recurrences of the primary lung cancer and/or development of a new primary lung cancer early enough to allow potentially curative retreatment. A standard surveillance program for these patients, coordinated by a multidisciplinary tumor board and overseen by the physician who diagnosed and initiated therapy for the original lung cancer, is recommended based on periodic visits with chest imaging studies and counseling patients on symptom recognition. Smoking cessation and, if indicated, facilitation in participation in special programs is recommended for all patients following curative intent therapy for lung cancer.

Conclusions: The current evidence favors follow-up of complications related to curative intent therapy, and a surveillance program at regular intervals with imaging and review of symptoms. Smoking cessation after curative intent therapy to prevent recurrence of lung cancer is strongly supported by the available evidence.

Key Words: lung cancer • metachronous tumors • recurrence • surveillance