Servicio de Cirugía Torácica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
Servicio de Cirugía Torácica, Hospital Clínico Universitario de Valencia, Valencia, Spain.
Cir Esp (Engl Ed). 2022 Jun;100(6):320-328. doi: 10.1016/j.cireng.2022.05.024. Epub 2022 May 25.
The most effective treatment for lung cancer is complete lung resection, although recurrences reach up to 10% and the appearance of second neoplasms, up to 6%. Therefore, the follow-up of these patients will be essential for the early detection and treatment of these events; however there is no definition of the form, time and cadence of these follow-ups. In this consensus document, we try to define them based on the available scientific evidence. A critical review of the literature is carried out (meta-analysis, systematic reviews, reviews, consensus recommendations of scientific societies, randomized controlled studies, non-randomized controlled studies, observational studies and case series studies) and communications to the main congresses on oncology and thoracic surgery in Spanish, English and French. The evidences found are classified following the GRADE system. It is defined according to the existing evidence that the patient resected for lung cancer should be followed up, as well as that this follow-up should be close during the first years and with CT (not being necessary to follow up with PET-CT, biomarkers or bronchoscopy). Cessation of smoking is also recommended in this follow-up.
肺癌最有效的治疗方法是完全肺切除术,尽管复发率高达 10%,第二肿瘤的发生率高达 6%。因此,对这些患者进行随访对于早期发现和治疗这些事件至关重要;然而,目前还没有关于这些随访的形式、时间和频率的定义。在本共识文件中,我们试图根据现有科学证据对其进行定义。对文献进行了批判性回顾(荟萃分析、系统评价、综述、科学学会的共识建议、随机对照研究、非随机对照研究、观察性研究和病例系列研究),并向西班牙语、英语和法语的主要肿瘤学和胸外科大会进行了交流。根据 GRADE 系统对发现的证据进行了分类。根据现有证据,我们确定应对肺癌切除术后的患者进行随访,并且在最初几年内应密切随访,并进行 CT 检查(不需要进行 PET-CT、生物标志物或支气管镜检查)。在随访过程中还建议患者戒烟。