Disruption of radiological surveillance following a global health crisis in resected lung cancer

Fuentes-Martín, Álvaro ; Martínez-Hernández, Néstor J. ; Embun, Raul (Universidad de Zaragoza) ; Muñoz Moreno, María Fé ; Cilleruelo Ramos, Ángel ;

Resumen: Objectives: Radiological surveillance after curative-intent lung cancer resection is essential for early detection of recurrence and second primary tumors. Large-scale health emergencies can compromise oncologic follow-up. This study quantifies the impact of a health crisis on radiological surveillance in a national cohort of resected lung cancer patients.
Methods: A time-segmented observational cohort study was performed using data from the prospective, multicenter GEVATS registry. Surveillance density (CT/month) was evaluated across three predefined periods: pre-pandemic (baseline), state of alarm (maximum healthcare restrictions), and post-alarm (recovery phase). The population at risk was updated for each period. Subgroup analyses during the post-alarm phase assessed prioritization according to neoadjuvant treatment, pathological stage, age, and comorbidity.
Results: Among 2382 eligible patients, surveillance density declined progressively from the pre-pandemic period (0.157 ± 0.079 CT/month) to the state of alarm (0.098 ± 0.071 CT/month). In the post-alarm phase, density dropped sharply to 0.023 ± 0.018 CT/month (equivalent to one CT every 3.6 years), representing a 76.5% reduction compared with the state-of-alarm period (p < 0.001). This under-surveillance was generalized, with no significant differences by pathological stage (p = 0.084), age (p = 0.564), or comorbidity (p = 0.872). Only prior neoadjuvant therapy was associated with a slightly higher density (p = 0.040).
Conclusions: A prolonged health crisis resulted in a profound and persistent reduction in radiological surveillance after lung cancer resection, without evidence of risk-based prioritization. These findings support the need for contingency frameworks within clinical guidelines to preserve continuity of oncologic follow-up during future health emergencies.

Idioma: Inglés

DOI: 10.1111/1759-7714.70264

Año: 2026

Publicado en: THORACIC CANCER 17, 5 (2026), e70264 [7 pp.]
ISSN: 1759-7706

Tipo y forma: Article (Published version)

Área (Departamento): Área Cirugía (Dpto. Cirugía)