Barriers to surveillance imaging adherence in early-staged lung cancer

Journal of Thoracic Disease

article

Ian C. Bostock¹  Wayne Hofstetter¹  Reza Mehran¹  Ravi Rajaram¹  David Rice¹  Boris Sepesi¹  Stephen Swisher¹  Ara Vaporciyan¹  Garrett Walsh¹  Mara B. Antonoff¹ 

[1] Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center

关键词: Early-stage lung cancer;    surveillance imaging;    imaging guidelines;    survivorship care;    surveillance guidelines;   

DOI  :  10.21037/jtd-21-1254

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Background: Frequency of post-treatment surveillance is highly variable following curative resection of non-small cell lung cancer (NSCLC). We sought to characterize surveillance practices after lobectomy for early-stage NSCLC and to identify the impact of various demographic factors on patterns of surveillance. Methods: We included patients who underwent anatomic lobectomy for pathologic stage I NSCLC from 2007–2017. Demographic characteristics, post-operative imaging studies (internal and external), and travel distance were recorded. We defined the minimal standard of surveillance imaging studies (MSSIS) as ≥7 studies in the first 5 years (computed tomography/positron emission tomography). Patient sex, ethnicity, marital status, and distance traveled were evaluated as predictors of imaging receipt. Standard descriptive statistics, univariate, and multivariate analysis (MVR) were performed. Results: A total of 1,288 patients were included. The mean age was 65.5±10.1 years, 589 (45.7%) were male, 1,081 (83.9%) were Caucasian, and 924 (71.7%) were married. Only 464 (36%) achieved MSSIS; being married [75.6% (351/464) vs. 68.8% (567/824), P=0.01] and having larger tumor size (2.63±0.04 vs. 2.49±0.05 cm, P=0.03) were both associated with MSSIS. Patients residing <100 miles from the hospital were more likely to have MSSIS, and more imaging at 24 months (4.1±2.2 vs. 3.7±2.0; P=0.006), 60 months (8.0±5.1 vs. 6.6±4.2, P=0.001) and overall (10±7.3 vs. 8.2±6.3; P=0.001). On MVR, tumor size and marital status were associated with MSSIS. Conclusions: Two-thirds of patients at our institution did not undergo recommended surveillance imaging. Tumor size, being married, and living <100 miles from the medical center were associated with an increased number of imaging studies and greater adherence to guidelines.

【 授权许可】

Unknown