Early Diagnosis of Metachronous Colorectal Carcinoma

Törnqvist, Anders; Ekelund, G; Leandoer, L

doi:10.1111/j.1445-2197.1981.tb05980.x

Cited by 21 publications

(9 citation statements)

References 6 publications

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“…However, it is important to ensure that the colon has been completely visualised prior to resection or soon thereafter, because a proportion of patients will have synchronous polyps and cancers at the time of the original resection 17 18. The age at which endoscopic surveillance should cease should be a decision between doctor and patient and based on the risks and benefits of colonoscopy and comorbidities.…”

Section: Guidelines For Follow-up After Resection Of Colorectal Cancermentioning

confidence: 99%

Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002)

Cairns

Scholefield

Steele

et al. 2010

Gut

1,039

826

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The British Society of Gastroenterology (BSG) and the Association of Coloproctology for Great Britain and Ireland (ACPGBI) commissioned this update of the 2002 guidance. The aim, as before, is to provide guidance on the appropriateness, method and frequency of screening for people at moderate and high risk from colorectal cancer. This guidance provides some new recommendations for those with inflammatory bowel disease and for those at moderate risk resulting from a family history of colorectal cancer. In other areas guidance is relatively unchanged, but the recent literature was reviewed and is included where appropriate.

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Section: Guidelines For Follow-up After Resection Of Colorectal Cancermentioning

confidence: 99%

Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002)

Cairns

Scholefield

Steele

et al. 2010

Gut

1,039

826

View full text Add to dashboard Cite

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“…All patients with a previous colorectal cancer are at increased risk for the development of metachronous colonic neoplasms. 22,23 Polyps can be identified and removed by colonoscopy, and a second cancer should be viewed as a failure of follow-up in this high-risk population. Regular surveillance can also lead to the identification of other health problems and provides a forum for discussion of new treatments, relevant changes in family history, and genetic issues.…”

Section: Rationale and Aimsmentioning

confidence: 99%

Follow-Up Recommendations for Colon Cancer

Buie

Attard

2005

Clinics in Colon and Rectal Surgery

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Recent evidence suggests that intensive follow-up after curative resection of colorectal cancer is associated with a small but significant improvement in survival. Regimens that employ cross-sectional imaging and carcinoembryonic antigen determination appear to have the greatest benefit. A risk-adapted approach to follow-up, intensively following patients at highest risk of recurrence, increases efficacy and cost-effectiveness. Ongoing improvements in risk stratification, disease detection, and treatment will increase the benefits of postoperative surveillance. Large randomized controlled trials are needed to determine the optimal surveillance regimen and must include an analysis of survival, quality of life, and cost-effectiveness to assess efficacy properly.KEYWORDS: Colorectal neoplasm, neoplasm recurrence/detection, neoplasm metastasis/diagnosis, surveillance, follow-up, survivalObjectives: Upon completion of this article, the reader should be able to: (1) describe the primary and secondary goals of surveillance following curative resection of colorectal cancer; and (2) summarize the evidence in favor of intensive surveillance, recognizing its limitations and the issues that need additional clarification.

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“…Surveillance remains a cornerstone approach to detect recurrence at an early stage [ 11 , 12 ] and consequently to plan further therapeutic strategies. Although several meta-analyses have been performed on the positive effects of the follow-up on CC prognosis [ 13 , 14 ], international guidelines are not in accordance on appropriate tests and their time frequency to optimize surveillance [ 15 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Surveillance for early stages of colon cancer: potentials for optimizing follow-up protocols

et al. 2015

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BackgroundAlthough several meta-analyses showed the positive effects of follow-up on the prognosis of colon cancer (CC), international guidelines are not in accordance on appropriate tests and their time frequency to optimize surveillance. Furthermore, stratified strategies based upon risk grading have not been implemented. This approach may be useful to rationalize resources.MethodsFrom 2006, all patients operated for an early stage CC (I, IIA, IIB) according to the 7th edition of the AJCC-2010 classification entered in a prospective surveillance program in accordance to our local guidelines. Patients who underwent surgical resection after 2009 have been excluded to guarantee at least a 5-year follow-up. Classic histopathologic prognostic factors such as grade, T and N status, lymphatic and vascular invasion were assessed. Moreover, tumor budding and tumor-to-stroma proportion were evaluated.ResultsWe had complete records of 196 patients. Distribution was as follows: 65 (33.2 %) in stage I, 122 (62.2 %) in stage IIA, and 9 (4.6 %) in stage IIB. Eleven patients (5.6 %) had a disease recurrence (local or distant). The median recurrence time was 20 months (range 6–48). Nine patients (82 %) had recurrence with 24 months, and 91 % were asymptomatic and detected by ultrasound or CT scan. According to the log-rank test, the risk factors with significant effect on the disease-free survival (DFS) were the number of lymph nodes <12 (p = 0.027) and the vascular invasion (p = 0.021), while for the overall (OS), only the vascular invasion was significant (p = 0.043). By the univariate and multivariate analyses, DSF was significantly lower in patients with less than 12 nodes removed, with vascular invasion, and with left of double cancer. OS was negatively affected only by vascular invasion despite the hazard ratios were similar to DSF. Stage IIB was associated with a threefold-increased risk of reduced OS and DSF.ConclusionsStages I and IIA appear to behave similarly and should be considered as true early stages. The detection of fibrosis and budding do not seem to add valuable information for prognosis. In early CC stages, the surveillance program should be maximized within the first two years.

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Early Diagnosis of Metachronous Colorectal Carcinoma

Cited by 21 publications

References 6 publications

Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002)

Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002)

Follow-Up Recommendations for Colon Cancer

Surveillance for early stages of colon cancer: potentials for optimizing follow-up protocols

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