Nine studies (eight observational and one RCT) were included in the review (1,669 participants, range 75 to 358). The RCT failed to report how the randomisation sequence was generated and whether treatment allocation was concealed. Seven of the observational studies were retrospective database cohort designs. The one prospective cohort study was considered to be relatively robust.
No significant difference was found between intensive follow-up and less intensive follow-up on overall survival for NSCLC (HR 0.83, 95% CI 0.66 to 1.05; four studies) and SCLC and advanced NSCLC (HR 0.86, 95% CI 0.65 to 1.13; two studies) subgroups. There was evidence of substantial heterogeneity for SCLC and advanced NSCLC subgroup analysis (Ι²=65%).
Asymptomatic recurrence was associated with a significantly longer survival time than symptomatic recurrence in patients with NSCLC after curative intent (OR 0.61, 95% CI 0.50 to 0.74; four studies); this outcome was not a predefined outcome of interest.
Quality of life outcomes were reported only in the RCT. A significant difference was found in favour of nurse-led (intensive) follow-up compared with standard care on measures of quality of life (dyspnoea less severe at three months, p=0.03; improved emotional functioning, p=0.03; less peripheral neuropathy at 12 months, p=0.05). No significant difference was found between intensive and less intensive follow-up for time to detection of recurrence (three studies) after curative treatment.