Efficacy of contrast versus non-contrast CT surveillance among patients surviving two years without recurrence after surgery for stage I lung cancer

Le résumé fourni par la source

Contrast-enhanced chest CT (CECT) is more sensitive than non-contrast-enhanced chest CT (NCECT), but NCECT may have comparable efficacy in detecting new primary lung cancer among stage I NSCLC survivors after two years of surveillance. This study aimed to evaluate the efficacy of NCECT versus CECT for surveillance among stage I NSCLC patients surviving two years after curative resection without disease recurrence. We conducted a retrospective cohort study of patients with stage I NSCLC who underwent curative-intent lung resection between January 2009 and December 2017 using the Registry for Thoracic Cancer Surgery at the Samsung Medical Center, Seoul, Korea. Overall survival, recurrence-free survival, and cost effectiveness were compared between patients undergoing surveillance with CECT and NCECT. Among 3248 patients, 1002 (38.8%) patients underwent NCECT surveillance. During a median follow-up of 2.3 years (interquartile range, 1.5-3.9 years), a total of 208 deaths were observed. Although patients undergoing NCECT surveillance had 0.04 more deaths per 100 person-year compared with patients undergoing CECT surveillance (95% CI -0.36 to 0.44), this difference did not reach statistical significance (1.27 vs. 1.31 per 100 person-years; HR, 1.10; 95% CI 0.81-1.50). Regarding cost effectiveness, CECT group had a gain of 0.024 quality-adjusted life-year but $785 higher total cumulative cost per patient compared to NCECT. There was no difference in recurrence and mortality between NCECT and CECT for surveillance among stage I NSCLC patients who survived two years after surgery without disease recurrence. Further randomized clinical trials are required to confirm the findings.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.