Systematic Postoperative Radiologic Follow-up in Patients With Non–Small Cell Lung Cancer for Detecting Second Primary Lung Cancer in Stage IA

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Abstract
IT IS ESTIMATED that 169 400 people will be diagnosed as having lung cancer in the United States in 2002.1 The 5-year cure rate has risen from 6% to 14% during the past 50 years. Of patients who survive a first non–small cell lung cancer (NSCLC), many develop a second cancer, either a second primary lung cancer (SPLC) or locally recurrent lung cancer (LRLC). Survival after recurrent lung cancer has been dismal owing to the inability to diagnose these lesions at an early stage. Indeed, 38% of SPLCs are not resected because of locally advanced tumors at diagnosis.2 Survival after SPLC ranges from 4% to 32% in various series,3-5 and LRLCs have 2-year survival of approximately 23%. Because of these poor results, some experts6,7 believe that comprehensive postsurgical follow-up by thoracic surgeons is not indicated.