Jiang Chenyu, Zhang Yang, Deng Penghao, Lin Han, Fu Fangqiu, Deng Chaoqiang, Chen Haiquan
Department of Thoracic Surgery and State Key Laboratory of Genetic Engineering, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.
Institute of Thoracic Oncology, Fudan University, Shanghai, People's Republic of China.
JTO Clin Res Rep. 2024 Jun 27;5(8):100701. doi: 10.1016/j.jtocrr.2024.100701. eCollection 2024 Aug.
Non-small cell lung cancer recurrence after curative-intent surgery remains a challenge despite advancements in treatment. We review postoperative surveillance strategies and their impact on overall survival, highlighting recommendations from clinical guidelines and controversies. Studies suggest no clear benefit from more intensive imaging, whereas computed tomography scans reveal promise in detecting recurrence. For early-stage disease, including ground-glass opacities and adenocarcinoma in situ or minimally invasive adenocarcinoma, less frequent surveillance may suffice owing to favorable prognosis. Liquid biopsy, especially circulating tumor deoxyribonucleic acid, holds potential for detecting minimal residual disease. Clinicopathologic factors and genomic profiles can also provide information about site-specific metastases. Machine learning may enable personalized surveillance plans on the basis of multi-omics data. Although precision medicine transforms non-small cell lung cancer treatment, optimizing surveillance strategies remains essential. Tailored surveillance strategies and emerging technologies may enhance early detection and improve patients' survival, necessitating further research for evidence-based protocols.
尽管治疗方面取得了进展，但根治性手术后非小细胞肺癌的复发仍然是一个挑战。我们回顾了术后监测策略及其对总生存期的影响，重点介绍了临床指南中的建议和争议。研究表明，更密集的影像学检查没有明显益处，而计算机断层扫描在检测复发方面显示出前景。对于早期疾病，包括磨玻璃影、原位腺癌或微浸润腺癌，由于预后良好，较少频率的监测可能就足够了。液体活检，尤其是循环肿瘤脱氧核糖核酸，在检测微小残留病方面具有潜力。临床病理因素和基因组图谱也可以提供有关特定部位转移的信息。机器学习可能基于多组学数据实现个性化监测计划。尽管精准医学改变了非小细胞肺癌的治疗方式，但优化监测策略仍然至关重要。量身定制的监测策略和新兴技术可能会加强早期检测并提高患者生存率，因此需要进一步研究以制定基于证据的方案。
