Does methodic long-term follow-up affect survival after curative resection of colorectal carcinoma?

Abstract

Records of 487 patients in long-term follow-up after Ro resection of colorectal carcinomas between January 1, 1980 and December 31, 1989 were analyzed. Every patient underwent regular examinations according to a defined schedule after curative resection of colorectal carcinoma. The date of evaluation was June 31, 1991. During a median observation time of 48 months (range, 15-132 months), tumor recurrence was observed in 149 patients (30.6 percent), with 56.4 percent of these suffering from tumor-associated symptoms. As the primary manifestation of tumor recurrence, only distant metastases (DM) were found in 76 patients (51 percent), only local recurrence (LR) in 46 patients (30.9 percent), and both DM and LR in 27 patients (18.1 percent). Patients with rectal carcinoma developed LR more frequently (P < 0.05) (19.5 percent) than patients with colon carcinoma (11.8 percent). The probability of developing distant metastases was not different (P < 0.05) for colon or rectal carcinoma but depended on primary tumor stage (P < 0.05). Only 36 patients (24.2 percent) with recurrence could undergo further curative resection. Fifty patients (33.5 percent) were given palliative therapy, and 63 patients (42.3 percent) were given no oncologic treatment. Only 9 of the 36 patients (6 percent of all recurrence patients) undergoing Ro resection were free of tumor for more than two years. In no case was a third Ro resection possible. The survival time of these patients was increased significantly after Ro resection of tumor recurrence (P = 0.03). Our study suggests that only a very few patients may live longer as a result of regular follow-up programs after curative resection for colorectal carcinoma.

Follow-up after Colorectal Cancer Surgery

“…The sensitivity of CEA assay to detect asymptomatic recurrences is 50 Á/70% (7,9,18,112,113). This percentage is higher for liver metastases than for local recurrences (9) and at the same level as that for CT and ultrasonography, but its specificity is lower (114). The use of individual cut-off levels for CEA has been shown to increase the sensitivity for tumour detection (115).…”

Patient experiences of nurse-led telephone follow-up following treatment for colorectal cancer

“…In the United Kingdom (UK), five year survival for those diagnosed at an early stage (Dukes A) is currently over 90%; those diagnosed at an early stage have a better prognosis than those who present at a later stage of disease (Cancer Research UK, 2014). However, despite most patients undergoing potentially curative surgery, 30-50% will develop recurrent disease and five year survival for advanced colorectal cancer is less than 5% (Young & Rea, 2001;Bohm et al, 1993). Incidence is strongly related to age; in the UK approximately 43% of bowel cancer cases were diagnosed in people aged 75 years and over between (Cancer Research UK, 2014.…”

Surveillance of patients following surgery with curative intent for colorectal cancer

“…Around 20% of patients with colorectal cancer will have evidence of metastatic disease at presentation, and one third of patients undergoing surgical management with curative intent will subsequently relapse, resulting in significant morbidity, and the majority of these die of their disease [1,[4][5][6][7][8][9][10][11][12][13] . Relapse most often presents within 3 years, but rarely can occur up to 10 years after resection of primary disease [14][15][16][17][18][19][20] .…”