Background: There is no established follow-up strategy in non-small cell lung cancer patients after complete resection. Follow-up regimens are different between nations, institutions, and surgeons. We tried to investigate the role of annual abdominal ultrasonographic examination in completely resected NSCLC patients.
Methods: We reviewed 265 consecutive patients who had their NSCLC completely resected at our institution from July 1992 through December 2000 and were followed by a single surgeon. Annual abdominal ultrasonography was performed until 5 years after resection. Chest CT and abdominal CT are not included in our routine follow-up program. Instead, we used ultrasonography to survey the abdomen because abdominal ultrasonography is less costly than abdominal CT, is non-invasive, and does not require contrast media.
Results: A total of 892 ultrasonographic examinations were performed. Fifty-nine (22.3%) patients developed recurrence. Annual ultrasonography detected lesions suspicious of recurrence in 15 patients. Further work-up diagnosed NSCLC recurrence in 2 (0.8%) patients (multiple liver metastases in one and right adrenal metastasis in one). The two patients soon developed disseminated disease and died in less than a year.
Conclusions: Annual abdominal ultrasonography in the follow-up protocol for completely resected NSCLC patients was not beneficial. Our experience in the present study may be used as valid evidence to exclude abdominal ultrasonography from future trials comparing follow-up regimens after complete resection of NSCLC. A better follow-up strategy needs to be established.