A recent study from Samsung Medical Center, Seoul, evaluated the efficacy of non-contrast-enhanced chest CT (NCECT) compared to traditionalcontrast-enhanced chest CT (CECT) for surveillance among stage I non-small cell lung cancer (NSCLC) patients who had survived two years following curative surgery. The findings of the study suggest comparable efficacy between the two imaging methods, raising significant questions about the standard practices for post-operative monitoring.
With increasing numbers of lung cancer survivors due to advancements in treatment options, proper surveillance practices have become increasingly important. The research team aimed to determine whether NCECT could serve as an effective alternative to CECT for these patients, potentially saving resources and reducing risks associated with iodine-based contrasts.
Conducted using data from the Registry for Thoracic Cancer Surgery at Samsung Medical Center, the retrospective cohort study spanned patients who underwent curative-intent lung resection between January 2009 and December 2017. It focused on those who remained disease-free two years post-surgery.
Among the 3,248 patients included for analysis, 1,002 (38.8%) opted for NCECT for their surveillance. The study followed patients over a median period of 2.3 years, during which 208 deaths were recorded. Although NCECT patients exhibited slightly higher mortality rates, differences were statistically insignificant. Analyzing patients' overall survival and recurrence-free survival rates, researchers sought to determine the cost-effectiveness of each imaging technique as well.
Results revealed no significant discrepancies between the two groups concerning mortality rates and recurrence. The notable quote from the study articulated, "We observed no differences in recurrence and mortality between NCECT and CECT for postoperative surveillance among stage I NSCLC patients who survived two years after surgery without disease recurrence."
Cost-effectiveness analyses also played a pivotal role in the study's conclusion. While CECT displayed slight advantages in patient quality-adjusted life years, the increased costs associated with the use of contrasts meant it fell short of being cost-effective when compared to NCECT. This analysis highlighted the growing importance of monitoring healthcare expenditure, particularly amid rising medical costs.
While the findings provide some reassurance on the comparability of NCECT as part of surveillance practices, they also underline the necessity of continued research. The authors concluded, "Further randomized clinical trials are required to confirm the findings," hinting at the necessity for future studies to revisit these assertions.
The results of this study mark a significant advancement for NSCLC patient care, encouraging healthcare providers to carefully evaluate surveillance imaging modalities and emphasizing the potential of NCECT as both efficient and cost-effective for long-term monitoring of lung cancer survivors.