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Intensive surveillance following curative treatment of colorectal cancer allows effective treatment of recurrence even if limited to 4 years.

Abstract：

BACKGROUND:Current evidence suggests a survival benefit to post-operative surveillance following curative colorectal cancer resection; however, there is still no consensus on the optimal duration and form. OBJECTIVES:The objective is to prospectively audit outcomes of an intensive colorectal cancer follow-up scheme for time to recurrence and survival. METHODS:We used a surveillance protocol designed to incorporate regular clinical, biochemical, radiological and endoscopic measures at pre-defined intervals. SETTING:The setting was a Department of Colorectal Surgery in a Tertiary Academic Centre. Follow-up was led by specially trained colorectal nurses in conjunction with surgeons. PATIENTS:Consecutive patients who had undergone curative treatment for colorectal cancer were included in this study. MAIN OUTCOMES:Outcomes were measured in terms of overall survival and disease recurrence. RESULTS:There were 436 patients entered into follow-up, all treated with curative intent. Mean age 65.9 years (SD 12.9 years) and 240 male (55.0 %). Ninety-four patients (21.5 %) with stage I disease, 119 (27.3 %) stage IIa, 30 (6.9 %) stage IIb, 18 (4.1 %) stage IIIa, 78 (17.9 %) stage IIIb, 45 (10.4 %) stage IIIc and 52 (11.9 %) stage IV. Overall median survival was 37.5 months for all patients, (range 0.0-207.8 months). Ninety-two (21.1 %) cancer-related deaths were recorded during the course of the study. The overall 5-year actuarial cancer-related survival was 81.7 %. There was a 40.3 % 5-year actuarial survival was recorded in patients with 39 a recurrence, 57.7 % in patients treated with further curative 40 intent and 27.7 % in patients who received palliative treatment 41 (P < 0.001). Ninety-seven percent of recurrences were detected within 4 years of curative treatment. CONCLUSIONS:This follow-up protocol confers an 81 % overall 5-year actuarial survival. Our study suggests that surveillance after curative resection can be limited to 4 years, which would lead to detection of over 97 % of all recurrences.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Adams K,Higgins L,Beazley S,Papagrigoriadis S

doi

10.1007/s00384-015-2356-x

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

1677-84

issue

eissn

0179-1958

issn

1432-1262

pii

10.1007/s00384-015-2356-x

journal_volume

pub_type

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Intensive surveillance following curative treatment of colorectal cancer allows effective treatment of recurrence even if limited to 4 years.