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(Chest. 1997;111:99-102.)
© 1997 American College of Chest Physicians

How Tumor Stage Affects Surgeons' Surveillance Strategies After Lung Cancer Surgery

Frank E. Johnson MD1; Keith S. Naunheim MD1; Margaret A. Coplin MS1; and Katherine S. Virgo PhD1

1 From the Department of Surgery St. Louis University Health Sciences Center and Surgical Service, St. Louis Department of Veterans Affairs Medical Center

The factors that influence decision making among surgeons are not well understood. We evaluated how tumor stage in patients subjected to potentially curative surgery for lung cancer affects the self-reported follow-up strategies employed by practicing surgeons. Hypothetical patient profiles and a detailed questionnaire based on these profiles were mailed to the 3,700 members of the Society of Thoracic Surgeons. The effect of TNM stage on the surveillance strategies chosen by the respondents was analyzed. All of the ten most commonly employed surveillance modalities were ordered significantly more frequently with increasing TNM stage, although the differences are small. Only 23% of respondents modified their strategies according to the patient's TNM stage. This effect persisted through 5 years of follow-up. We conclude that most surgeons performing surveillance after potentially curative surgery for otherwise healthy patients with lung cancer use the same follow-up strategy irrespective of TNM stage. These data should help in the design of prospective trials of this topic.

Key Words: lung cancer • medical decision making • patient care • postoperative surveillance • surgery • survey • TNM • tumor stage

Submitted on May 8, 1996
Accepted on July 22, 2007




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