BACKGROUND:The most common complication preventing outpatient management after percutaneous CT-guided lung biopsy (PTLB) is the occurrence of pneumothorax requiring drainage. We previously developed a pragmatic score to predict the risk of clinically relevant pneumothorax after PTLB (hereafter called the CAPAD score), to guide patient management. OBJECTIVES:To externally validate the CAPAD score in an independent cohort, with a specific focus on its ability to rule out pneumothorax requiring drainage after PTLB. METHOD:We retrospectively analysed a pre-existing institutional database of consecutive adult patients undergoing CT-guided PTLB at Bichat-Claude-Bernard University Hospital (Paris, France) between 1 January 2015 and 31 December 2017. The CAPAD score combines five variables: COPD, Anterior PTLB approach, more than one Pleural crossing, pneumothorax ≥10 mm on the end-of-procedure CT (post-procedural immediate pneumothorax), and skin-pleura Distance ≤30 mm, with a pre-specified cut-off of 73 points. The primary endpoint was the diagnostic performance of the score for post-PTLB pneumothorax on the 4-6 h control CXR and secondary endpoint was its performance for pneumothorax requiring drainage. RESULTS:The CAPAD score was computable in 313 of 474 patients. Pneumothorax occurred in 95 patients (30.4%), and 23 patients (7.3%) required drainage. At the pre-specified cut-off of 73, the score had a C-index of 0.77, a sensitivity of 75%, a specificity of 56%, a negative predictive value (NPV) of 84% and a positive predictive value of 43% for any post-PTLB pneumothorax. For pneumothorax requiring drainage, a score < 73 was associated with a 2.0% risk (3/147), corresponding to a NPV of 98%. CONCLUSION:Our pragmatic CAPAD score demonstrated a good prognostic performance for predicting the risk of post-procedural pneumothorax, achieve a NPV of 98% for pneumothorax requiring drainage.

Therapeutic cancer vaccines aim to expand tumor-antigen-specific T lymphocytes to eliminate cancer cells selectively. Recent advances in identifying neoantigens arising from genomic mutations in tumor cells, along with progress in vaccine-platform engineering, particularly in messenger RNA technologies, have revitalized the clinical development of cancer vaccines. Promising data from clinical trials of adjuvant vaccination in early-stage disease demonstrate the interest of vaccination for preventing recurrence. In this review, we describe the immunological rationale of cancer vaccines in the early stages of cancer. We also discuss the rationale for neoadjuvant cancer vaccination in combination with cotherapy such as chemotherapy or immune checkpoint inhibitors (ICIs).

Introduction Les gaz du sang artériels (GDS) sont le « gold standard » pour l’évaluation de l’efficacité de la ventilation non invasive (VNI) sur l’hématose. Il existe depuis de nombreuses années, des moniteurs permettant d’estimer de façon continue et non invasive la pression partielle artérielle en dioxyde de carbone (PaCO2) par une mesure de la pression transcutanée en dioxyde de carbone (PtCO2). La fiabilité et la précision des capnographes pour estimer la PaCO2 pendant la VNI diurne ne sont pas claires dans la littérature chez les patients atteints d’insuffisance respiratoire chronique (IRC) stable. Méthodes Cinquante patients ont été inclus dans notre étude monocentrique rétrospective. Nous avons évalué la corrélation entre la PaCO2 mesurée par les GDS avant et à 30minutes de l’instauration de la VNI, et la PtCO2 (dérive instrumentale non corrigée et corrigée) mesurée 1minute après les GDS par le capnographe SenTec®. Résultats Il n’y avait pas de différence significative entre la PaCO2 et la PtCO2avant et à 30minutes de traitement par VNI, que la dérive instrumentale de la PtCO2 soit corrigée ou non. Les limites d’accord entre les 2 mesures étaient de [–6,15 ; +7,27] mmHg avant introduction de la VNI et de [–7,00 ; +8,18] mmHg après 30minutes de VNI. Seulement 7/98 (7 %) valeurs de PtCO2 présentaient une différence significative de plus de 7,5mmHg avec les valeurs appariées de PaCO2. La tendance de la capnie relevée par les 2 méthodes de mesure (GDS et capnographe) pendant 30minutes de VNI était identique dans 82 % des cas. Conclusion La capnographie est une méthode non invasive d’estimation continue de la PaCO2 en journée, permettant en pratique clinique, une titration optimale des paramètres de la VNI lors de son instauration et une connaissance fiable de l’évolution de la PtCO2 des patients lors des réévaluations de la VNI sans qu’il soit nécessaire de recourir aux GDS plus invasifs. Cependant, son application en routine chez des patients IRC stables impose la connaissance technique du moniteur ainsi que ses limites.

OBJECTIVES:This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare, via a network meta-analysis, the effectiveness and safety of different immunotherapy agents that are administered in a perioperative setting to people with resectable non small-cell lung cancer To perform indirect comparisons in order to generate a clinically meaningful hierarchy of perioperative strategies of immunotherapy administration for overall survival in operable people with resectable non small-cell lung cancer.

OBJECTIVES:This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To assess the prognostic value of measuring pretreatment baseline blood eosinophil levels in adults receiving systemic treatment for any stage of non-small cell lung cancer.

La chirurgie exérèse est la pierre angulaire de la prise en charge des CBNPC résécables de stades I à III. La chimiothérapie, néoadjuvante ou adjuvante, à base de platine est depuis longtemps associée à la chirurgie pour les patients atteints d'une maladie résécable de stade II-III, bien que les avantages soient modestes, avec une augmentation de la survie globale d'environ 5 %. Récemment, l'immunothérapie a été intégrée aux schémas thérapeutiques néoadjuvant, adjuvant et péri-opératoire sur la base de données démontrant une amélioration de la survie sans événement (SSE), de la survie sans maladie (SSM) ainsi que de la survie globale, pour les CBNPC de stades localisés ou localement avancés, résécables, sans addiction oncogénique. Deux essais de phase 3 ont montré un bénéfice en adjuvant avec autorisation européenne mais n'ont pas de prise en charge en France. Six essais de phase 3 Checkmate-816, AEGEAN, Checkmate-77T, NeoTORCH, KEYNOTE-671, et RATIONAL-315 ont montré un bénéfice de l'association d'un inhibiteur de points de contrôle immunitaire à la chimiothérapie en situation néoadjuvante ou périopératoire. Les résultats de Checkmate-816 ont permis le remboursement du nivolumab, en association à une chimiothérapie à base de sel de platine dans le traitement néoadjuvant des patients adultes, atteints d'un CBNPC résécable à haut risque de récidive, dont les tumeurs expriment PD-L1 au seuil > 1%, non mutée EGFR, ni transloquée ALK.

Immune checkpoint inhibitors (ICIs) dramatically improve the prognosis of many malignancies but at the cost of numerous side effects, which may limit their benefits. Acute kidney injury associated with immune checkpoint inhibitors most frequently are acute tubulointerstitial nephritis (ATIN), but various cases of glomerulonephritis have also been reported. Herein, we report a case of severe IgA nephropathy (IgAN) associated with ICIs and carry out a literature review. IgAN was diagnosed in a median time of 5 months (range 1-12 months) after the initiation of ICIs, with heterogeneous severity, and usually treated by corticosteroid and discontinuation of ICIs. In contrast to our case, renal outcomes in literature were often favorable, with recovery of renal function and a reduction in proteinuria on treatment. Although IgAN related to ICIs is a much rarer complication than ATIN, it may still be underdiagnosed. Careful questioning and screening for asymptomatic hematuria should be performed before using ICIs.

Objectives This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: We aim to compare overall survival in people with recurrence and second primary lung cancer (SPLC) after lung cancer surgery. If survival differs between those people categorised as having index lung cancer recurrence and those categorised as having SPLC, it might be possible to identify the definition that has the best discriminatory capacity from the various published definitions of these conditions, so that it can be used in future.

Le COVID long correspond aux symptômes persistants à 4 semaines d’une infection à SARS-CoV-2, alors même que l’infection est contrôlée et guérie. Les plaintes sont variées et les mécanismes physiopathologiques non totalement compris. Dyspnée et fatigue musculaire sont parmi les symptômes les plus souvent rapportés. L’exploration fonctionnelle à l’exercice (EFX) est un examen reconnu pour l’exploration de la dyspnée inexpliquée. Dans les pathologies respiratoires chroniques, la réhabilitation respiratoire a démontré son efficacité en termes d’amélioration de la qualité de vie, de la dyspnée et de la tolérance à l’effort. La publication d’études concernant les EFX et la réhabilitation respiratoire est nécessaire pour améliorer la compréhension et la prise en charge du COVID long. Les données concernant les EFX montrent que la persistance de symptômes à distance de l’infection aiguë par le SARS-CoV-2 peut être en lien avec un déconditionnement à l’effort, d’autant plus marqué si l’infection a nécessité une prise en charge en réanimation, une dysautonomie cardiaque dans les suites d’infections critiques ou, enfin, de respirations dysfonctionnelles, fréquentes dans les suites d’infections légères. Ces limitations justifient une réhabilitation respiratoire dont l’efficacité est démontrée, quelle que soit la gravité initiale de l’infection, dans les suites immédiates d’une hospitalisation, mais également à distance. Long COVID refers to persistent symptoms, lasting more than 4 weeks after acute SARS-CoV-2 infection, even though the infection itself has been successfully controlled and remedied. Patient complaints are diverse, and the underlying physiopathological mechanisms are not well understood. Dyspnea and muscle fatigue are among the most commonly reported symptoms. Cardiopulmonary exercise test (CPET) has been recognized as a useful tool in investigation of unexplained dyspnea. In patients with chronic lung disease, pulmonary rehabilitation is a program designed to counteract dyspnea, to increase exercise capacity and to improve quality of life. Publications on CPET and pulmonary rehabilitation are needed in order to deepen comprehension and enhance management of long-COVID-19. CPET reports have shown that symptoms persisting in the aftermath of acute SARS-CoV-2 infection may be related to deconditioning, a common occurrence after ICU stay, to cardiac dysautonomia subsequent to critical infections and, finally, to dysfunctional breathing subsequent to mild infections. These findings justify pulmonary rehabilitation, which has proven to be effective regardless of the severity of the initial infection, not only immediately after hospital discharge, but also at later points in time.

Purpose: The main objective of this study was to identify risk factors for post-percutaneous transthoracic lung biopsy (PTLB) pneumothorax and to establish and validate a predictive score for pneumothorax occurrence to identify patients eligible for outpatient care. Material and Methods: Patients who underwent PTLB between November 1, 2012 and March 1, 2017 were retrospectively evaluated for clinical and radiologic factors potentially related to pneumothorax occurrence. Multivariate logistic regression was used to identify risk factors, and the model coefficient for each factor was used to compute a score. Then, a validation cohort was prospectively evaluated from March 2018 to October 2019. Results: Among the 498 eligible patients in the study cohort, pneumothorax occurred in 124 patients (24.9%) and required drainage in 34 patients (6.8%). Pneumothorax risk factors were chronic obstructive pulmonary disease (OR 95% CI 2.28[1.18–4.43]), several passages through the pleura (OR 95% CI 7.71[1.95–30.48]), an anterior biopsy approach (OR 95% CI 6.36 3.82–10.58]), skin-to-pleura distance ≤30 mm (OR 95% CI 2.25[1.09–6.65]), and aerial effusion >10 mm (OR 95% CI 9.27 [5.16–16.65]). Among the 236 patients in the prospective validation cohort, pneumothorax occurred in 18% and 8% were drained. A negative score (<73 points) predicted a probability of pneumothorax occurrence of 7.4% and late evacuation of 2.5% (OR 95% CI respectively 0.18[0.08–0.39] and 0.15[0.04–0.55]) and suggested a reduced length of hospital stay (P=0.009). Conclusion: This predictive score for pneumothorax secondary to PTLB has high prognostic performance and accuracy to direct patients toward outpatient management. Clinical Trials: NCT03488043

Nous présentons ici un cas original de tularémie grave avec une atteinte cutanée, des adénopathies et une péricardite sur terrain d’immunodépression ; pathologie d’incidence croissante en Europe à cause du réchauffement climatique.Une patiente de 33 ans a consulté pour altération de l’état général, anorexie, hyperthermie à 38,3 °C, dyspnée et toux sèche évoluant depuis plusieurs jours. Son seul antécédent était une maladie de Crohn sous anti-TNF alpha depuis 3 mois. L’interrogatoire retrouvait des randonnées forestières régulières. Un traitement par amoxicilline/acide clavulanique ainsi qu’une anticoagulation curative étaient débutés après diagnostic initial retenu de pneumopathie infectieuse associée à une embolie pulmonaire. La patiente a reconsulté 2 semaines après pour une dégradation clinique associée à des lésions cutanées. La tomodensitométrie retrouvait une majoration des adénopathies médiastinales et un épanchement péricardique circonférentiel de 5 mm. La sérologie tularémie revenait positive en IgG à 400 UI/mL. Malgré une antibiothérapie adaptée par ciprofloxacine, la patiente a présenté une nouvelle dégradation clinique brutale. Une péricardiocentèse était réalisée dont l’analyse retrouve un exsudat à prédominance neutrophilique et une PCR Francisella tularensis fortement positive. De la gentamicine a été associée, permettant une résolution des symptômes.La tularémie fait partie des pathologies dont le tableau atypique avec péricardite, favorisée par un terrain d’immunodépression, aggrave le pronostic. Le réchauffement climatique influence l’épidémiologie des pathologies d’inoculations, dont la tularémie, la rendant plus fréquente.We present an original severe case of tularemia with cutaneous damage, lymphadenopathy and pericarditis ; pathology of increasing incidence in Europe due to global warming.A 33-years-old women consulted emergency unit for altered general condition, anorexia, hyperthermia at 38,3 °C, dyspnea and dry cough evolving for few days. Her only history was Crohn's disease with introduction of an anti-TNF alpha for 3 months. The interrogation found regular forest walks ». Treatment with Amoxicillin/clavulanic acid 1 g 3 times daily and curative anticoagulation was started after the initial diagnosis of infectious pneumonia associated with pulmonary embolism. The patient reconsulted 2 weeks later for clinical deterioration associated with skin lesions. The chest CT scan showed increased mediastinal lymphadenopathy and a circumferential pericardial effusion ; quantified at 5 mm on transthoracic ultrasound. Tularemia serology was positive in IgG at 400 IU/mL. Despite an adapted antibiotic therapy with Ciprofloxacin, the patient presented a new brutal clinical deterioration. A pericardiocentesis was performed and the analysis revealed a predominantly neutrophilic exudate and a strongly positive PCR Francisella tularensis. Gentamicin 5 mg/kg was associated allowing a resolution of the symptoms.Tularemia is one of the pathologies whose atypical presentation with pericarditis (favored by a certain immunodepression) worsens the prognosis. Global warming influences the epidemiology of inoculation diseases, including tularemia, making it more frequent.

PURPOSE Universal cancer peptide–based vaccine (UCPVax) is a therapeutic vaccine composed of two highly selected helper peptides to induce CD4+ T helper-1 response directed against telomerase. This phase Ib/IIa trial was designed to test the safety, immunogenicity, and efficacy of a three-dose schedule in patients with metastatic non–small-cell lung cancer (NSCLC). PATIENTS AND METHODS Patients with refractory NSCLC were assigned to receive three vaccination doses of UCPVax (0.25 mg, 0.5 mg, and 1 mg) using a Bayesian-based phase Ib followed by phase IIa de-escalating design. The primary end points were dose-limiting toxicity and immune response after three first doses of vaccine. Secondary end points were overall survival (OS) and progression-free survival at 1 year. RESULTS A total of 59 patients received UCPVax; 95% had three prior lines of systemic therapy. No dose-limiting toxicity was observed in 15 patients treated in phase Ib. The maximum tolerated dose was 1 mg. Fifty-one patients were eligible for phase IIa. The third and sixth dose of UCPVax induced specific CD4+ T helper 1 response in 56% and 87.2% of patients, respectively, with no difference between three dose levels. Twenty-one (39%) patients achieved disease control (stable disease, n = 20; complete response, n = 1). The 1-year OS was 34.1% (95% CI, 23.1 to 50.4), and the median OS was 9.7 months, with no significant difference between dose levels. The 1-year progression-free survival and the median OS were 17.2% (95% CI, 7.8 to 38.3) and 11.6 months (95% CI, 9.7 to 16.7) in immune responders ( P = .015) and 4.5% (95% CI, 0.7 to 30.8) and 5.6 months (95% CI, 2.5 to 10) in nonresponders ( P = .005), respectively. CONCLUSION UCPVax was highly immunogenic and safe and provide interesting 1-year OS rate in heavily pretreated advanced NSCLC.

Après un séjour en réanimation pour COVID-19, certains patients présentent une dyspnée persistante, une asthénie et des anomalies fonctionnelles respiratoires. Ces anomalies peuvent être liées à une faiblesse musculaire inspiratoire (FMI). Un examen clinique, des explorations fonctionnelles respiratoires (EFR) comprenant l’exploration des muscles respiratoires avec mesure de la pression inspiratoire maximale (PIM) et de la pression inspiratoire narinaire lors d’un sniff test (SNIP), un scanner thoracique, une polygraphie respiratoire nocturne, un test de marche de 6 minutes (TM6), une évaluation de la dyspnée (échelle mMRC) et une évaluation de la qualité de vie (questionnaire SF-36) ont été réalisés chez 85 patients ayant été hospitalisés en réanimation pour un syndrome de détresse respiratoire aiguë (SDRA) lié au COVID-19 au centre hospitalier universitaire de Besançon, à 3, 6 et 12 mois après le début des symptômes. La FMI était définie comme une PIM inférieure à 80 cmH2O chez l’homme et 70 cmH2O chez la femme et une SNIP inférieure à 70 cm H2O chez l’homme et 60 cmH2O chez la femme. L’incidence de la FMI a été évaluée à 3, 6 et 12 mois et les patients ont été séparés en 2 groupes selon la présence ou non d’une FMI afin d’en étudier ses facteurs de risque. Au total, 85 patients ont été inclus à 3 mois après le début des symptômes, 80 à 6 mois et 73 à 12 mois (Fig. 1). Un patient n’ayant pas pu réaliser les EFR à 3 mois, les analyses ont été réalisées sur 84 patients à 3 mois. L’âge médian était de 68,2 ans, 78,6 % étaient des hommes, 35,4 % étaient obèses, 92,9 % avaient des comorbidités. L’incidence de la FMI était de 21,42 % à 3 mois, 12,7 % à 6 mois et 4,5 % à 12 mois. Les patients présentant une FMI à 3 mois avaient une durée de séjour en réanimation, de ventilation mécanique et d’utilisation de curares plus longues. Un trouble ventilatoire restrictif était plus fréquent chez les patients présentant un FMI (p = 0,0055). La distance parcourue au TM6 était plus faible chez les patients avec FMI, sans différence significative (p = 0,0527). La qualité de vie évaluée par le SF-36 n’était pas différente entre les 2 groupes (p = 0,5373). La dyspnée était présente chez 63,8 % des patients à 3 mois, 56,4 % à 6 mois et 52,1 % à 12 mois. L’âge élevé, la durée d’hospitalisation supérieure à 44 jours, la durée de séjour en réanimation supérieure à 17 jours, l’utilisation de curares supérieure à 8 jours, le nombre de cures de décubitus ventral supérieur à 7 et la durée de ventilation mécanique étaient des facteurs de risque de FMI. La FMI persistait à 3 mois chez une proportion significative de patients après une hospitalisation en réanimation pour un SDRA lié à COVID-19, ce qui peut expliquer la persistance de la dyspnée. Elle était fortement corrélée à la durée de la ventilation mécanique et à la durée du séjour en réanimation. Elle s’est améliorée à 6 et 12 mois, ainsi que la dyspnée.

Background Cardiopulmonary exercise testing (CPET) is an important clinical tool that provides a global assessment of the respiratory, circulatory and metabolic responses to exercise which are not adequately reflected through the measurement of individual organ system function at rest. In the context of critical COVID-19, CPET is an ideal approach for assessing long term sequalae. Methods In this prospective single-center study, we performed CPET in 60 patients, 12 months after a critical COVID-19 infection that required intensive care unit (ICU) treatment. Lung function at rest and chest computed tomography (CT) scan were also performed. Results Twelve months after severe COVID-19 pneumonia, the majority of the patients had a peak O 2 uptake (V’O 2 ) considered within normal limits. However, length of ICU stay remained an independent predictor of V’O 2 . Surprisingly, more than half of the patients with a normal peak predicted V’O 2 showed ventilatory inefficiency during exercise (high VE/VCO 2 ratio and high VE/VCO 2 slope) with increased physiological dead space (VD/Vt) and low end-tidal CO 2 partial pressure (PETCO 2 ) values. This impairment was even more pronounced in patients with persistent dyspnea. Notably, peak VD/Vt values were positively correlated with peak D-Dimer plasma concentrations from blood samples collected during ICU stay. Conclusions Even if reduced exercise capacity was rare 12 months after critical COVID-19, more than half of the patients with normal exercise capacity showed ventilatory inefficiency.

INTRODUCTION:Long COVID refers to persistent symptoms, lasting more than 4 weeks after acute SARS-CoV-2 infection, even though the infection itself has been successfully controlled and remedied. Patient complaints are diverse, and the underlying physiopathological mechanisms are not well understood. Dyspnea and muscle fatigue are among the most commonly reported symptoms. STATE OF THE ART:Cardiopulmonary exercise test (CPET) has been recognized as a useful tool in investigation of unexplained dyspnea. In patients with chronic lung disease, pulmonary rehabilitation is a program designed to counteract dyspnea, to increase exercise capacity and to improve quality of life. PERSPECTIVES:Publications on CPET and pulmonary rehabilitation are needed in order to deepen comprehension and enhance management of long-COVID-19. CONCLUSIONS:CPET reports have shown that symptoms persisting in the aftermath of acute SARS-CoV-2 infection may be related to deconditioning, a common occurrence after ICU stay, to cardiac dysautonomia subsequent to critical infections and, finally, to dysfunctional breathing subsequent to mild infections. These findings justify pulmonary rehabilitation, which has proven to be effective regardless of the severity of the initial infection, not only immediately after hospital discharge, but also at later points in time.

Introduction. - We present an original severe case of tularemia with cutaneous damage, lymphadenopathy and pericarditis; pathology of increasing incidence in Europe due to global warming. Observation. - A 33-years-old women consulted emergency unit for altered general condition, anorexia, hyperthermia at 38,3 degrees C, dyspnea and dry cough evolving for few days. Her only history was Crohn's disease with introduction of an anti-TNF alpha for 3 months. The interrogation found regular forest walks". Treatment with Amoxicillin/clavulanic acid 1 g 3 times daily and curative anticoagulation was started after the initial diagnosis of infectious pneumonia associated with pulmonary embolism. The patient reconsulted 2 weeks later for clinical deterioration associated with skin lesions. The chest CT scan showed increased mediastinal lymphadenopathy and a circumferential pericardial effusion; quantified at 5 mm on transthoracic ultrasound. Tularemia serology was positive in IgG at 400 IU/mL. Despite an adapted antibiotic therapy with Ciprofloxacin, the patient presented a new brutal clinical deterioration. A pericardiocentesis was performed and the analysis revealed a predominantly neutrophilic exudate and a strongly positive PCR Francisella tularensis. Gentamicin 5 mg/kg was associated allowing a resolution of the symptoms. Conclusion. - Tularemia is one of the pathologies whose atypical presentation with pericarditis (favored by a certain immunodepression) worsens the prognosis. Global warming influences the epidemiology of inoculation diseases, including tularemia, making it more frequent. (c) 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.

The IFCT-0302 trial was a randomized multicenter trial, which found no benefit in overall survival in adding chest CT-scan and fiberoptic bronchoscopy (optional for adenocarcinomas) to a follow-up based on physical examination and chest x-ray in resected NSCLC. We present the results of patient-reported outcomes (PROs), a secondary endpoint of the IFCT-0302 trial. PROs consisted of Health-Related Quality of Life (HRQoL), assessed using the Short Form-12 (SF-12) questionnaire, and a penibility visual analogue scale (between 0 and 10), at randomization, every 6 months during 2 years and annually until 5 years or until disease progression or second primary cancer or death if they occurred before 5 years. Time to deterioration, used to analyze longitudinal HRQoL data, was defined as the interval between randomization and the occurrence of the first clinically relevant deterioration (5 points) compared to the HRQoL score at baseline. Between January 2005 and November 2012, 1775 patients were randomized in the IFCT-0302 trial. 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. 80.8% and 75.6% of patients completed questionnaires up to one year, respectively. There was no difference between groups in time to deterioration for the 2 dimensions of the SF-12 questionnaire: mental dimension [HR (the minimal follow-up group vs. the CT-based follow-up group): 0.92; 95%CI (0.80; 1.15); p=0.64] and physical dimension [HR: 0.87; 95%CI (0.71 ; 1.06) ; p=0.19]. Penibility was statistically greater in the CT-based follow-up group (p<0.0001), and was related to fiberoptic bronchoscopy. Analysis of PROs in the IFCT-0302 trial demonstrated that adding thoracic CT-scan in the follow-up after resection of NSCLC did not influence HRQoL but penibility was increased, due to fiberoptic bronchoscopy.