I've put 212,000 miles on my barge in the last 13 years. The only thing I've replaced are the self adjusters and (of course) a few sets of brake shoes and they work well. Having said that, all the stuff is available to rebuild them 'like new', so it wouldn't hurt.
I'm only speaking from my experience, but I think the biggest problem drum brakes have in our sort of car is lack of use. There's a lot of moving parts in drum brakes and they need to be moved regularly.