ABSTRACT
El tratamiento más efectivo para el cáncer de pulmón es la resección pulmonar completa, si bien las recidivas llegan hasta el 10% y la aparición de segundos primarios, hasta el 6%. Será, por tanto, indispensable el seguimiento de estos pacientes para la detección y tratamiento precoces de estos eventos; sin embargo, no existe una definición de la forma, tiempo y cadencia de estos seguimientos. En el presente documento de consenso, tratamos de definirlos con base en la evidencia científica disponible. Se realiza una revisión crítica de la bibliografía (metaanálisis, revisiones sistemáticas, revisiones, recomendaciones de consenso de sociedades científicas, estudios controlados aleatorizados, estudios controlados no aleatorizados, estudios observacionales y estudios de series de casos) y comunicaciones a los principales congresos de oncología y cirugía torácica en castellano, inglés y francés. Se clasifican las evidencias halladas siguiendo el sistema GRADE. Queda definido, según la evidencia existente, que se debe realizar un seguimiento del paciente resecado por cáncer pulmonar, así como que este seguimiento debe ser estrecho durante los primeros años y con realización de TC (no siendo necesario el seguimiento con tomografía por emisión de positrones-tomografía computarizada [PET-TC], biomarcadores o broncoscopia). Se recomienda también en ese seguimiento el cese del hábito tabáquico (AU)
The most effective treatment for lung cancer is complete lung resection, although recurrences reach up to 10% and the appearance of second neoplasms, up to 6%. Therefore, the follow-up of these patients will be essential for the early detection and treatment of these events; however, there is no definition of the form, time and cadence of these follow-ups. In this consensus document, we try to define them based on the available scientific evidence. A critical review of the literature is carried out (meta-analysis, systematic reviews, reviews, consensus recommendations of scientific societies, randomized controlled studies, non-randomized controlled studies, observational studies and case series studies) and communications to the main congresses on oncology and thoracic surgery in Spanish, English and French. The evidences found are classified following the GRADE system. It is defined according to the existing evidence that the patient resected for lung cancer should be followed up, as well as that this follow-up should be close during the first years and with CT (not being necessary to follow up with PET-CT, biomarkers or bronchoscopy). Cessation of smoking is also recommended in this follow-up (AU)
Subject(s)
Humans , Lung Neoplasms/surgery , Survival Analysis , Follow-Up Studies , Societies, Medical , ConsensusABSTRACT
Multidisciplinary care is needed to decide the best therapeutic approach and to provide optimal care to patients with lung cancer (LC). Multidisciplinary teams (MDTs) are optimal strategies for the management of patients with LC and have been associated with better outcomes, such as an increase in quality of life and survival. The Spanish Lung Cancer Group has promoted this review about the current situation of the existing national LC-MDTs, which also offers a set of excellence requirements and quality indicators to achieve the best care in any patient with LC. Time and sufficient resources; leadership; administrative and institutional support; and recording of activity are key factors for the success of LC-MDTs. A set of excellence requirements in terms of staff, resources and organization of the LC-MDT have been proposed. At last, a list of quality indicators has been agreed to achieve and measure the performance of current LC-MDTs.
Subject(s)
Lung Neoplasms/therapy , Patient Care Team , Quality Indicators, Health Care , Culturally Competent Care , Spain , HistologyABSTRACT
Multidisciplinary care is needed to decide the best therapeutic approach and to provide optimal care to patients with lung cancer (LC). Multidisciplinary teams (MDTs) are optimal strategies for the management of patients with LC and have been associated with better outcomes, such as an increase in quality of life and survival. The Spanish Lung Cancer Group has promoted this review about the current situation of the existing national LC-MDTs, which also offers a set of excellence requirements and quality indicators to achieve the best care in any patient with LC. Time and sufficient resources; leadership; administrative and institutional support; and recording of activity are key factors for the success of LC-MDTs. A set of excellence requirements in terms of staff, resources and organization of the LC-MDT have been proposed. At last, a list of quality indicators has been agreed to achieve and measure the performance of current LC-MDTs.
