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R. Karzijn



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    P1.05 - Poster Session with Presenters Present (ID 457)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Early Stage NSCLC
    • Presentations: 1
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      P1.05-065 - Usage of Chest Radiography or Computed Tomography in Post-Treatment Surveillance for Stage I and II NSCLC: Influence on Survival (ID 5524)

      14:30 - 15:45  |  Author(s): R. Karzijn

      • Abstract

      Background:
      Survivors of stage I and II non-small-cell lung cancer (NSCLC) have higher risk of developing a recurrence of disease or a second primary lung cancer compared to the general population. Post-treatment surveillance (visits and radiological imaging) is needed for early recognition. Although a myriad of international guidelines exist regarding post-treatment surveillance no consensus has derived yet. The aim of this study was to further establish the appropriate follow-up modality: chest radiography with or without a computed tomography (CT) scan.

      Methods:
      In this retrospective study all patients diagnosed with a recurrence of previously treated stage I and II NSCLC between 2008 and 2014 at St Antonius Hospital, Nieuwegein the Netherlands, were included. We categorized patients after treatment in two imaging modality groups: one group received only chest radiographs (CR group) and the other group received ≥ one thoracic CT scan (CT group). The overall survival (OS), 1- and 3-yearssurvival and progression free survival (PFS) were compared between the groups by using the Kaplan-Meier survival, the log rank-test and the Cox proportional hazard model.

      Results:
      73 patients were enrolled; 50 patients in the CR group and 23 patients in the CT group. The median overall survival was 22.1 months (interquartile range (IQR) = 14.2-39.2 months) in the CR group compared to 27.2 months (IQR= 18.5-53.2 months) in the CT group (p = 0.12). After adjustment for the Eastern Cooperative Oncology Group (ECOG) performance score and morphology was made, both the overall survival (hazard ratio (HR) = 1.43, 95% confidence interval (CI) = 0.76-2.70, p = 0.27) and the progression free survival (HR = 1.16, 95% CI = 0.65 – 2.07, p = 0.63) were not different in the CR group compared to patients in the CT group. There was no significant difference in the 1- and 3-yearssurvival either. The 1-yearssurvival was 80% in the CR group versus 91% in the CT group (HR = 5.50, 95% CI = 0.52-58.01, p = 0.16) and the 3-yearssurvival was 30% versus 39% (HR = 1.50, 95% CI = 0.74-3.01, p = 0.29).

      Conclusion:
      We showed that follow-up with a chest radiography, in patients with earlier diagnosed and curative treated stage I and II NSCLC, did not give inferior clinical outcomes compared to follow-up with a CT scan. Although more investigation is needed, this study might indicate that there is no need for a CT scan as standardized follow-up.