Detection of lung cancer relapse using self-reported symptoms transmitted via an Internet Web-application: pilot study of the sentinel follow-up

We aimed to investigate whether patient self-evaluated symptoms transmitted via Internet can be used between planned visits to provide an early indication of disease relapse in lung cancer. Between 2/2013 and 8/2013, 42 patients with lung cancer having access to Internet were prospectively recruited to weekly fill a form of 11 self-assessed symptoms called "sentinel follow-up". Data were sent to the oncologist in real-time between planned visits. An alert email was sent to oncologist when self-scored symptoms matched some predefined criteria. Follow-up visit and imaging were then organized after a phone call for confirming suspect symptoms. Weekly and monthly compliances, easiness with which patients used the web-application and the accuracy of the sentinel follow-up for relapse detection were assessed and compared to a routine visit and imaging follow-up. Median follow-up duration was 18 weeks (8-32). Weekly and monthly average compliances were 79 and 94 %, respectively. Sixty percents of patients declared to be less anxious during the few days before planned visit and imaging with the sentinel follow-up than without. Sensitivity, specificity, positive, and negative predictive values provided by the sentinel (planned imaging) follow-up were 100 %(84 %), 89 %(96 %), 81 %(91 %), and 100 %(93 %), respectively and well correlated with relapse (p chi (2) < 0.001). On average, relapses were detectable 5 weeks earlier with sentinel than planned visit. An individualized cancer follow-up that schedule visit and imaging according to the patient status based on weekly self-reported symptoms transmitted via Internet is feasible with high compliance. It may even provide earlier detection of lung cancer relapse and care.