***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To assess the effectiveness of nurse led follow up in the management of patients with lung cancer . Design : R and omised controlled trial . Setting : Specialist cancer hospital and three cancer units in southeastern Engl and Participants : 203 patients with lung cancer who had completed their initial treatment and were expected to survive for at least 3 months . Intervention : Nurse led follow up of out patients compared with conventional medical follow up . Outcome measures : Quality of life , patients ' satisfaction , general practitioners ' satisfaction , survival , symptom-free survival , progression-free survival , use of re sources , and comparison of costs . Results : Patient acceptability of nurse led follow up was high : 75 % ( 203/271 ) of eligible patients consented to participate . Patients who received the intervention had less severe dyspnoea at 3 months ( P=0.03 ) and had better scores for emotional functioning ( P=0.03 ) and less peripheral neuropathy ( P=0.05 ) at 12 months . Intervention group patients scored significantly better in most satisfaction subscales at 3 , 6 , and 12 months ( P<0.01 for all subscales at 3 months ) . No significant differences in general practitioners ' overall satisfaction were seen between the two groups . No differences were seen in survival or rates of objective progression , although nurses recorded progression of symptoms sooner than doctors ( P=0.01 ) . Intervention patients were more likely to die at home rather than in a hospital or hospice ( P=0.04 ) , attended fewer consultations with a hospital doctor during the first 3 months ( P=0.004 ) , had fewer radiographs during the first 6 months ( P=0.04 ) , and had more radiotherapy within the first 3 months ( P=0.01 ) . No other differences were seen between the two groups in terms of the use of re sources . Conclusion : Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes We investigated whether intensive follow-up leads to earlier diagnosis of recurrence , more effective treatment , and longer survival in patients with small cell lung cancer ( SCLC ) who had shown a complete or partial response to first-line chemotherapy . The subjects of this retrospective study were 94 patients with SCLC who had shown a complete or partial response to first-line chemotherapy . The patients were separated into two arms : an intensive follow-up arm in which patients underwent regular blood tests , chest radiography , computed tomography of the chest and upper abdomen , magnetic resonance or computed tomography of the brain , and bone scintigraphy bimonthly for 6 months and then quarterly for 1.5 years ; and a nonintensive follow-up arm in which these examinations were performed at the physician 's discretion . All patients also underwent interviews and physical examinations monthly for 2 years and bimonthly for a further 3 years . Patient characteristics did not differ significantly between the arms . Disease recurred in 55 of 62 patients of the intensive arm and 29 of 32 patients of the nonintensive arm . Asymptomatic recurrences were detected more frequently in the intensive arm than in the nonintensive arm . The response rate to salvage therapy among all patients with recurrent disease was significantly higher in the intensive arm ( 61.8 % ) than in the nonintensive arm ( 37.9 % ; p=0.04 ) . Both median postrelapse survival and overall median survival were significantly longer in the intensive arm ( 9 and 20 months , respectively , p=0.04 and p=0.001 ) than in the nonintensive arm ( 4 and 13 months , respectively ) . Intensive follow-up helps detect recurrence earlier , enhances the effectiveness of treatment , and lengthens survival in patients with SCLC . Well- design ed prospect i ve , r and omized trials including a cost-benefit analysis are needed to compare intensive and nonintensive follow-up regimens Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses  after treatment for breast cancer . Design A two centre r and omised equivalence trial in which women remained in the study for a mean of 24 months . Setting Outpatient clinics in two NHS hospital trusts in the north west of Engl and Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence . Interventions Participants were r and omised to traditional hospital follow-up ( consultation , clinical examination , and mammography as per hospital policy ) or telephone follow-up by specialist nurses ( consultation with structured intervention and mammography according to hospital policy ) . Main outcome measures Psychological morbidity ( state-trait anxiety inventory , general health question naire ( GHQ-12 ) ) , participants ’ needs for information , participants ’ satisfaction , clinical investigations ordered , and time to detection of recurrent disease . Results The 95 % confidence interval for difference in mean state-trait scores adjusted for treatment received ( −3.33 to 2.07 ) was within the predefined equivalence region ( −3.5 to 3.5 ) . The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics ( intention to treat P<0.001 ) . The numbers of clinical investigations ordered did not differ between groups . Recurrences were few ( 4.5 % ) , with no differences between groups for time to detection ( median 60.5 ( range 37 - 131 ) days in hospital group v 39.0 ( 10 - 152 ) days in telephone group ; P=0.228 ) . Conclusions Telephone follow-up was well received by participants , with no physical or psychological disadvantage . It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics . Trial registration National Cancer Research Institute 1477 BACKGROUND Although a minimal follow-up with periodic clinic visits and chest radiographs is usually recommended after complete operation for non-small cell lung cancer , the ideal follow-up has not been defined yet . Objectives of this prospect i ve study were to determine the feasibility of an intensive surveillance program and to analyze its influence on patient survival . METHODS Follow-up consisted of physical examination and chest roentgenogram every 3 months and fiberoptic bronchoscopy and thoracic computed tomographic scan with sections of the liver and adrenal gl and s every 6 months . Influence of patient and recurrence characteristics on survival from recurrence was successively analyzed using the log-rank test and a Cox model adjusted for treatment . RESULTS Among the 192 eligible patients ,  recurrence developed in 136 patients ( 71 % ) and was asymptomatic in 36 patients ( 26 % ) . In 35 patients , recurrence was asymptomatic and detected by a scheduled procedure : thoracic computed tomographic scan in 10 ( 28 % ) patients and fiberoptic bronchoscopy in 10 . Fifteen patients ( 43 % ) had a thoracic recurrence treated with curative intent . From the date of recurrence , 3-year survival was 13 % in all patients and 31 % in asymptomatic patients whose recurrence was detected by a scheduled procedure . Asymptomatic recurrences ( p < 0.001 ) , female sex ( p < 0.001 ) , performance status 2 or less ( p = 0.01 ) , and age 61 years or younger ( p = 0.01 ) were shown to be significantly favorable prognostic factors . CONCLUSIONS This intensive follow-up is feasible and may improve survival by detecting recurrences after surgery for non-small cell lung cancer at an asymptomatic stage The aims of this study were ( a ) to estimate the prevalence of pain and eight other common symptoms in a large population of patients with advanced cancer from different palliative care centers , and ( b ) to assess the differences in prevalence of the symptoms by primary site . In 1990 - 1991 , the prevalence of eight major symptoms and performance status were assessed prospect ively among 1840 cancer patients in seven hospices in Europe , the United States , and Australia . The data were collected at each institution using structured data collection sheets from the World Health Organization 's ( WHO ) Cancer and Palliative Care Unit . The prevalence of moderate to severe pain was 51 % , ranging from 43 % in stomach cancer to 80 % in gynecological cancers . Nausea was most prevalent in gynecological ( 42 % ) and stomach ( 36 % ) cancers , and dyspnea ( 46 % ) in lung cancer . There were statistically significant differences in the prevalence of most symptoms depending on the primary site of cancer and the hospice . Population -based follow-up studies are needed to document the incidence and prevalence of symptoms throughout the course of the disease Objectives The first objective was to identify variations in patient management practice patterns after  potentially curative lung cancer surgery . Patient management practice patterns were expected to range from intensive follow-up to no active surveillance . The second objective was to measure whether intensity of follow-up was related to patient outcomes . Methods An 18-month retrospective analysis was conducted of 182 patients with low TNM stage ( ≤IIIA ) lung cancer who were surgically treated with curative intent over the 11 -year period from 1982 through 1992 at the St. Louis Department of Veterans Affairs Medical Center . Results Patients were followed for a mean of 3.3 years , until death or the end of the study . Analyses of diagnostic test and outpatient visit frequency distributions and cluster analyses facilitated the identification of 62 nonintensively followed patients and 120 intensively followed patients . Both groups were comparable at baseline , and there were no significant differences in patient outcomes attributable to intensity of follow-up . Intensively followed patients did , however , live an average of 192 days longer than nonintensively followed patients . Conclusions Significant variations in follow-up practice patterns can exist within a single health care facility . In this analysis , variations in test and visit frequency did not result in statistically significant differences in patient outcomes , though the survival difference between groups suggests that some benefit might exist . Only well- design ed prospect i ve trials are likely to answer the question of what constitutes optimal follow-up after potentially curative lung cancer treatment The majority of patients with lung cancer have incurable disease from presentation and a survival measured in months . Treatments offered to these patients are aim ed at the palliation of symptoms with either radiotherapy or chemotherapy , or with supportive measures . It has been traditional to offer regular outpatient follow-up after initial palliative treatment . Further treatment options , which may be limited , are usually reserved for the recurrence of troublesome symptoms . A pilot ' open access ' lung cancer clinic has been set up . Rather than have regular follow-up at the hospital , patients who have completed initial palliative treatments are discharged to the community with follow-up by their general practitioner and Macmillan nurse . Review at the open access clinic can be arranged at short notice if requested by the patient , carers , general practitioner or Macmillan nurse . The outcomes and level of satisfaction of patients , their relatives and staff to this method of follow-up were found to be positive . Open access follow-up may be useful for many patients after the completion of initial palliative treatment BACKGROUND The aim of this study was to determine the risk of overall death in long-term survivors ( > 5 years ) after pneumonectomy for non-small cell lung cancer ( NSCLC ) , and to establish the optimal follow-up strategy for these patients . METHODS We analyzed a single-center experience with 94 long-term survivors who underwent pneumonectomy ( group A ) for NSCLC between January 1992 and December 2000 . Prospect i ve tumor registry data were compared with data for 147 long-term survivors who underwent lobectomy ( group B ) during the same period . RESULTS Clinical characteristics at the time of operation differed between the two groups with more squamous histology , larger tumor size , and more advanced stage in group A compared with group B. During follow-up , late lung cancer relapses were rare in both groups ( 2.1 % vs 1.4 % ) , and second primary malignancies were less frequent in group A ( 2.1 % vs 9.5 % , p = 0.032 ) . The overall 10-year survival rate was lower in group A than in group B ( 67.3 % vs 82.8 % ) ; however , there was no significant difference in lung cancer-specific survival ( 93.5 % vs 95.1 % ) . Intercurrent disease was the leading cause of death in group A ( 14 patients , 14.9 % ) , most commonly respiratory failure result ing from community-acquired pneumonia . CONCLUSION Late cancer relapse or second primary malignancies were rare in long-term survivors after pneumonectomy , but the overall mortality remained high as a result of intercurrent diseases . Continued surveillance should focus on prevention , early detection and aggressive management of intercurrent disease during follow-up care of these patients BACKGROUND AND PURPOSE The European Society for Therapeutic Radiology and Oncology was funded by the EU for a project on Recording providing Education , and Ameliorating the Consequences of Treatment ( REACT ) . An important aim of follow-up ( FU ) after treatment for cancer is to detect various events associated with disease recurrence or metastatic spread or severe treatment-related complications as early as possible . Each tumour type may show a specific pattern and timing of these events related to different prognostic factors . The aim of this study was to propose a way of defining an optimal timing schedule for follow-up after treatment based on the analysis of failure patterns determined from follow-up data from prospect i ve clinical trials . MATERIAL AND METHODS Cox proportional hazards model was used to identify prognostic factors associated with each failure type ( loco-regional recurrence ( LR ) , distant metastasis ( DM ) or side effects ( SE ) ) . Competing risks methods were applied to estimate the cumulative incidence functions ( CIF ) , adjust 
    Output:
    
Some benefit was noted from intensive follow-up strategies .