CHEST Guidelines-Follow-up-and-Surveillance-of-the-Patient-With-Lun

Follow-up-and-Surveillance-of-the-Patient-With-Lun

Pdf Summary

The 2013 ACCP (American College of Chest Physicians) guidelines update provides evidence-based recommendations for the follow-up and surveillance of lung cancer patients after curative-intent therapy. This comprehensive review examines how various post-treatment interventions, such as imaging studies, health-related quality-of-life (HRQOL) measures, tumor markers, and bronchoscopy influence outcomes following treatment.<br /><br />Key findings suggest that periodic chest CT imaging is beneficial for detecting recurrences in patients who have undergone curative-intent surgical resection of non-small cell lung cancer (NSCLC). Physicians who are able to integrate patient clinical findings into decision-making are essential to follow-up strategies, while biomarker testing outside of clinical trials is not generally recommended.<br /><br />Surveillance bronchoscopy is suggested for specific scenarios, such as in patients with early central airway squamous cell carcinoma treated via curative-intent photodynamic therapy, and for those with intraluminal bronchial carcinoid tumors who have received curative-intent bronchoscopic treatment.<br /><br />The guidelines emphasize the limited availability of well-designed studies focusing on follow-up and surveillance concerns impacting survival and quality of life (QOL) after therapy. It advocates for more targeted research to understand how surveillance practices—including imaging, QOL assessments, tumor markers, and bronchoscopy—affect patient outcomes, morbidity, survival, and healthcare costs.<br /><br />Several recommendations underscore the integration of validated HRQOL instruments during follow-up visits, underscoring their importance for interpreting patient recovery and targeting interventions for symptomatic or emotional challenges post-treatment.<br /><br />Ultimately, the guidelines signal an evolving need to develop personalized follow-up and surveillance strategies tailored to individual patient risk profiles, tumor biology, and potential for recurrence. Such approaches are likely to maximize therapeutic outcomes, promote patient-centered care, and ensure judicious use of healthcare resources.

Keywords

ACCP guidelines

lung cancer follow-up

curative-intent therapy

chest CT imaging

non-small cell lung cancer

biomarker testing

surveillance bronchoscopy

quality of life assessments

personalized surveillance

patient-centered care