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Impact of CT scan-based vs. minimal follow-up on patient-reported outcomes after surgery for non-small cell lung cancer in IFCT-0302 phase III trial

In brief

Routine post-surgery chest CT scans do not boost patient quality of life

In the IFCT-0302 trial of 1,775 resected NSCLC patients, serial chest CT surveillance was compared with minimal follow-up using chest X-rays. Over five years, time to deterioration in both mental and physical health scores was virtually identical between groups, showing no quality-of-life benefit from routine CT scans. The finding suggests imaging intensity should be weighed against cost and radiation without expecting patient-reported gains.

Journal
The Journal of thoracic and cardiovascular surgery (Q1)
Published
22 September 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Guillaume Eberst, Julie Henriques, Pascal-Alexandre Thomas, Etienne Giroux-Leprieur, Olaf Mercier, Pierre-Benoît Pagès, et al.
PMID
42772370
DOI
10.1016/j.jtcvs.2026.08.031

Why clinicians should know about it

Abstract

PURPOSE: The randomized IFCT-0302 trial compared chest CT-scan to chest X-ray for surveillance follow-up in resected NSCLC. Chest CT-scan enabled the detection of more cases of early recurrence and second primary lung cancer, which were more amenable to curative-intent treatment but did not result in improved survival. After surgery for NSCLC, guidelines recommend a follow-up with chest CT-scan. Therefore, the impact of follow-up on patient health-related quality of life (HRQoL) needs to be considered. We present the results of patient-reported outcomes (PROs) of the IFCT-0302 trial. PATIENTS AND METHODS: Patients were randomly assigned to the CT-based follow-up group or to the minimal follow-up arm (clinic visits and chest x-rays). HRQoL were a prespecified secondary analysis of the IFCT-0302 trial. Procedures, including HRQoL assessed using the Short Form-12 (SF-12) questionnaire were repeated at randomization, every 6 months for 2 years and annually until 5 years. Time to deterioration (TTD) was used for longitudinal data. RESULTS: A total of 1775 patients were randomized. At baseline, 756 of the 888 patients (85.1%) in the minimal follow-up group had at least one HRQoL score available, and 747 of 887 (84.2%) in the CT-based follow-up group. There were no differences between groups in the TTD for the two dimensions of the SF-12 questionnaire: mental dimension [HR (CT-based follow-up group vs. minimal follow-up group): 0.97; 95% CI, 0.82-1.15; p = 0.74] and physical dimension [HR (CT-based follow-up group vs. minimal follow-up group): 1.13; 95% CI, 0.92-1.38; p = 0.24)]. CONCLUSIONS: No impact in HRQoL was demonstrated adding thoracic CT scans in the follow-up after resection of NSCLC.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.