Effect of More vs Less Frequent Follow-up Testing on Overall and Colorectal Cancer–Specific Mortality in Patients With Stage II or III Colorectal Cancer

Wille‐Jørgensen, Peer; Syk, Ingvar; Smedh, Kenneth; Laurberg, Søren; Nielsen, Dorte Guldbrand; Petersen, Sune Høirup; Renehan, Andrew G.; Horváth‐Puhó, Erzsébet; Påhlman, Lars; Sørensen, Henrik Toft

doi:10.1001/jama.2018.5623

Cited by 181 publications

(174 citation statements)

References 23 publications

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“…Studies in colorectal cancer suggest that more frequent specialised follow-up care, including more diagnostic investigations, have no effect on CR detection or survival (Snyder et al, 2018;Wille-Jørgensen et al, 2018). This indicates that improvements in the detection of CR should be based on increased focus on symptomatic presentation.…”

Section: Interpretation and Implicationsmentioning

confidence: 99%

Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice

et al. 2019

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Objective Specialised follow‐up care after cancer treatment is changing towards increased involvement of general practice. To ensure timely detection of new cancer events, knowledge is warranted on the timing of cancer recurrence (CR) and second primary cancer (SPC), including risk factors for CR. Methods This population‐based register study included 67,092 patients diagnosed with malignant melanoma, bladder, lung, ovarian, endometrial, colorectal and breast cancer in Denmark in 2008–2016. The time from primary cancer to CR or SPC and risk factors for prolonged time to CR were analysed and stratified on sex and primary cancer type. Results Cancer recurrence proportions ranged from 6% to 35%. The risk of CR increased profoundly within the first 3 years and then levelled off, except for breast cancer. A total of 3%–6% of patients had SPC, with monotonously increasing cumulative incidence proportions. Besides primary tumour characteristics, lower educational level, living alone and comorbidity were associated with earlier CR. For example, in female malignant melanoma, HRs and 95% confidence intervals were 0.47 (0.37–0.61) for high educational level, 1.40 (1.16–1.68) for living alone and 2.38 (1.53–3.70) for high comorbidity. Conclusion The results may inform stratified risk assessment in decision of frequency, location and duration of post‐cancer follow‐up care.

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Section: Interpretation and Implicationsmentioning

confidence: 99%

Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice

et al. 2019

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“…Stage IV renal adenocarcinoma presents an extremely low five-year survival rate of 0-10% [1], while the recurrence rate may be as high as 23% [2]. While the recurrence rate of colorectal carcinoma is similar to that of renal adenocarcinoma at 19.4% to 21.6%, the five-year survival rate is significantly higher at 88.6% to 89.4% [3]. Pancreatic ductal adenocarcinoma has an extremely low survival rate of 10% to 28% [4] after one year due to a very high recurrence rate of 65.5% [5].…”

Section: Introductionmentioning

confidence: 96%

The Canady Helios Cold Plasma Scalpel Significantly Decreases Viability in Malignant Solid Tumor Cells in a Dose-Dependent Manner

Rowe¹,

Cheng²,

Ly³

et al. 2018

Plasma

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Abstract:To determine appropriate treatment doses of cold atmospheric plasma (CAP), the Canady Helios Cold Plasma Scalpel was tested across numerous cancer cell types including renal adenocarcinoma, colorectal carcinoma, pancreatic adenocarcinoma, ovarian adenocarcinoma, and esophageal adenocarcinoma. Various CAP doses were tested consisting of both high (3 L/min) and low (1 L/min) helium flow rates, several power settings, and a range of treatment times up to 5 min. The impact of cold plasma on the reduction of viability was consistently dose-dependent; however, the anti-cancer capability varied significantly between cell lines. While the lowest effective dose varied from cell line to cell line, in each case an 80-99% reduction in viability was achievable 48 h after CAP treatment. Therefore, it is critical to select the appropriate CAP dose necessary for treating a specific cancer cell type.

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“…In this single-institution retrospective analysis we found marked rates antigen levels at high-frequency or low-frequency intervals. 16 The authors reported no significant difference in either 5-year overall mortality or colorectal cancer-specific mortality between groups. A retrospective study conducted by the Alliance for Clinical Trials in Oncology Cancer Surveillance Optimization Working Group reinforced these findings with data from the National Cancer Data Base demonstrating no significant association between the intensity of surveillance and detection of recurrent disease for patients with stage I, II, or III colorectal cancer.…”

Section: Discussionmentioning

confidence: 90%

“…In contrast, other literature challenges the assumption that increased postoperative surveillance necessarily portends better clinical outcomes. A recently published randomized clinical trial assigned patients with stage II or III colorectal cancer to cohorts that mandated computed tomography imaging and carcinoembryonic antigen levels at high‐frequency or low‐frequency intervals . The authors reported no significant difference in either 5‐year overall mortality or colorectal cancer‐specific mortality between groups.…”

Section: Discussionmentioning

confidence: 99%

Deficiencies in postoperative surveillance for veterans with gastrointestinal cancer

Taylor

Maloney

et al. 2018

Journal of Surgical Oncology

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Background and Objectives National guidelines for gastrointestinal (GI) cancers offer surveillance algorithms to facilitate detection of recurrent disease, yet adherence rates are unknown. We sought to characterize postoperative surveillance patterns for veterans with GI cancer at a tertiary care Veterans Affairs Hospital. Methods A single‐center retrospective cohort study identified patients who underwent surgical resection for colorectal, gastroesophageal or hepatopancreaticobiliary malignancy from 2010‐2016. We calculated the annual rate of cancer‐directed clinic visits and abdominal imaging and used National Comprehensive Cancer Network guidelines as a benchmark by which to assess adequate surveillance. Results Ninety‐seven patients met inclusion criteria. Median surveillance time was 1203 days. Overall, 44% of patients had insufficient surveillance. Specifically, 11% received no postoperative imaging and 7% had no cancer‐directed clinic visits. An additional 30% received less than recommended surveillance imaging and 12% attended fewer than recommended clinic visits. By disease site, insufficient imaging was most common for patients with hepatopancreaticobiliary cancer (63%), while inadequate clinic follow‐up was highest for colorectal cancer (24%). Conclusion A significant proportion of veterans with GI cancer received either inadequate postoperative surveillance based on national guidelines. This deficiency represents an opportunity for improvement through targeted efforts, including telemedicine and education of patients and providers.

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Effect of More vs Less Frequent Follow-up Testing on Overall and Colorectal Cancer–Specific Mortality in Patients With Stage II or III Colorectal Cancer

Abstract: clinicaltrials.gov Identifier: NCT00225641.

Cited by 181 publications

References 23 publications

Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice

Time from incident primary cancer until recurrence or second primary cancer: Risk factors and impact in general practice

The Canady Helios Cold Plasma Scalpel Significantly Decreases Viability in Malignant Solid Tumor Cells in a Dose-Dependent Manner

Deficiencies in postoperative surveillance for veterans with gastrointestinal cancer

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