STS, ESTS and JACS survey on surveillance practices after surgical resection of lung cancer

Abstract

Objectives: A 1995 survey of Society of Thoracic Surgeons (STS) members revealed wide variation in postresection lung cancer surveillance practices and pessimism regarding any survival benefit. We sought to compare contemporary practice patterns and attitudes among members of STS, European Society of Thoracic Surgeons (ESTS) and the Japanese Association for Chest Surgery (JACS).

Methods: A survey identical to the one conducted in 1995 was administered via mail or electronically. χ2 tests for associations were used to compare profiles of respondents and attitudes towards testing between groups. All the statistical tests were two-sided and P-values of 0.05 or less were considered statistically significant.

Results: A total of 2978 STS members (response rate 7.8%, n = 234), 1450 ESTS members (response rate 8.4%, n = 122) and 272 JACS (response rate 40.8%, n = 111) members were surveyed. Rate of guideline-recommended surveillance computed tomography was reported highest among ESTS respondents for stage I patients (22% ESTS, 3% STS and 6% JACS members, P < 0.001). However, both JACS and ESTS respondents reported higher rates of use of non-guidelines-recommended tests compared to STS respondents, which persisted on adjusted analyses. Regarding attitudes towards surveillance, more JACS and ESTS members either 'agree' or 'strongly agree' that routine testing for non-small-cell lung cancer recurrence results in potentially curative treatment (ESTS: 86%, STS: 70%, JACS: 90%, P < 0.001). Similarly, JACS and ESTS respondents believe that the current literature documents definitive survival benefits from routine follow-up testing (ESTS: 57%, STS: 30%, JACS: 62%, P < 0.001).

Conclusions: The Japanese attitude towards surveillance is similar to that of ESTS members potentially highlighting significant differences between European and Asian surgeons compared to STS members. These differences clearly highlight the need for better prospective studies and joint recommendations to globally standardize practice.

Keywords: Follow-up; Lung cancer; Lung resection; Surveillance; Survey.