Colorectal Cancer Surveillance: 2005 Update of an American Society of Clinical Oncology Practice Guideline

Abstract

Based on results from three independently reported meta-analyses of randomized controlled trials that compared low-intensity and high-intensity programs of colorectal cancer surveillance, and on recent analyses of data from major clinical trials in colon and rectal cancer, the Panel recommends annual computed tomography (CT) of the chest and abdomen for 3 years after primary therapy for patients who are at higher risk of recurrence and who could be candidates for curative-intent surgery; pelvic CT scan for rectal cancer surveillance, especially for patients with several poor prognostic factors, including those who have not been treated with radiation; colonoscopy at 3 years after operative treatment, and, if results are normal, every 5 years thereafter; flexible proctosigmoidoscopy [corrected] every 6 months for 5 years for rectal cancer patients who have not been treated with pelvic radiation; history and physical examination every 3 to 6 months for the first 3 years, every 6 months during years 4 and 5, and subsequently at the discretion of the physician; and carcinoembryonic antigen every 3 months postoperatively for at least 3 years after diagnosis, if the patient is a candidate for surgery or systemic therapy. Chest x-rays, CBCs, and liver function tests are not recommended, and molecular or cellular markers should not influence the surveillance strategy based on available evidence.

S3-Leitlinie – Kolorektales Karzinom

“…Eine Aktualisierung der ASCO-Leitlinien im Jahr 2005 führte zur Empfehlung von jährlichen CT-Abdomen-Untersuchungen über 3 Jahre [1277]. Die Kommission begründete ihre Entscheidung für den Einsatz des Abdomen-CTs in der Nachsorge mit der Arbeit von Chau et al [1278].…”

Early detection of recurrence by 18FDG-PET in the follow-up of patients with colorectal cancer

“…The preferred treatment for patients with recurrent disease is resection of the metastases in the liver or lung, and this can result in a 5-year survival rate of 35 -40% (Scheele et al, 1990;Fong et al, 1997). This is why these patients should be followed-up using either clinical or biological exams, as well as imaging procedures (Desch et al, 2005;Rodriguez-Moranta et al, 2006;Sjovall et al, 2007).…”

Trends in Follow-up and Preventive Care for Colorectal Cancer Survivors

“…Both the National Comprehensive Cancer Network and the American Society of Clinical Oncology Colorectal Cancer Surveillance Guidelines recommend a history and physical every 3 to 6 months for the first 2-3 years for stage 2 and 3 colorectal cancer survivors. [5][6][7][8] These guidelines do not, however, address who should be providing this follow-up care.…”