BACKGROUND Limited evidence is available on effectiveness of clinicoradiological follow-up of early-stage NSCLC patients. MAGRIT was a phase III adjuvant RCT conducted in surgically resected stage IB-IIIA NSCLC patients, in which all participants had a prospectively defined intensive clinicoradiological follow-up. METHODS At patient-level data, we analyzed detection modality of disease recurrences and new primary lung cancer (i.e. detected by clinicoradiological scheduled exams versus by interim unscheduled exams), features associated with higher risk of locoregional and/or distant recurrence, and recurrence rates over time. RESULTS In the 2261 patients studied, there was a significant association between the type of recurrence and the modality of detection: 88.4% (95% CI, 84%-91%) of the locoregional recurrences and 93.2% (95% CI, 84%-99%) of the new primary lung cancers were detected by scheduled exams, whereas this was only 68.7% (95% CI, 65%-73%) for distant metastases (p < 0.001). Survival of patients with locoregional recurrence or new primary lung cancer detected by scheduled exams was significantly better as compared with those detected by unscheduled exams (HR 0.56, 95% CI 0.36-0.87; p = 0.01). Survival was similarly poor in patients with distant recurrences, both with scheduled and unscheduled detection (3-year survival after recurrence 22.0% and 21.8%, respectively). Recurrence rate was the highest in the first 18 months after surgery-with a peak between month 6 and 12-decreasing thereafter. The hazard of a second primary lung cancer was constant over time. CONCLUSION Intensive follow-up is effective in detecting locoregional recurrences and second primary lung cancers, with impact on patients' survival but did not influence the detection of distant recurrences.

中文翻译：

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手术切除的非小细胞肺癌患者强化临床和放射学随访的有效性。分析来自前瞻性MAGRIT试验的2661名患者。

背景技术关于早期NSCLC患者的临床放射学随访有效性的证据有限。MAGRIT是在手术切除的IB-IIIA期非小细胞肺癌患者中进行的III期辅助RCT，其中所有参与者均进行了明确定义的强化临床放射学随访。方法在患者水平的数据上，我们分析了疾病复发和新发原发性肺癌的检测方式（即通过临床放射学定期检查与临时非定期检查进行检测），与局部和/或远距离复发风险较高相关的特征以及复发率时间。结果在研究的2261位患者中，复发类型与检测方式之间存在显着相关性：局部复发的88.4％（95％CI，84％-91％）和93.2％（95％CI）定期检查发现了84％-99％的新发原发性肺癌，而远处转移仅为68.7％（95％CI，65％-73％）（p <0.001）。定期检查发现的局部复发或新发原发性肺癌患者的存活率明显高于非定期检查发现的患者（HR 0.56，95％CI 0.36-0.87； p = 0.01）。有计划的和计划外的检测，远距离复发患者的生存率同样较差（复发后3年生存率分别为22.0％和21.8％）。复发率在手术后的前18个月最高，在第6个月至第12个月达到峰值，此后下降。随着时间的推移，第二原发性肺癌的危害是恒定的。