Follow-up after rectal cancer: developing and testing a novel patient-led follow-up program. Study protocol

Jakobsen, Ida Hovdenak; Juul, Therese; Bernstein, Inge; Christensen, Peter; Jensen, Frank Svendsen; Johansen, Christoffer; Larsen, Susie Lindhardt; Laurberg, Søren; Madsen, Mogens Rørbæk; Thorlacius-Ussing, Ole; Thaysen, Henriette Vind

doi:10.1080/0284186x.2016.1267400

Cited by 15 publications

(9 citation statements)

References 16 publications

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“…This study's focus lies on the quality of life of participating patients. An ongoing Danish randomized controlled trial is investigating remote follow-up as well, focusing on symptom burden and quality of life [26]. Two other RCTs, in Australia and in the Netherlands, are examining GP-led follow-up [27,28].…”

Section: Ongoing Studiesmentioning

confidence: 99%

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Qaderi

Swartjes

Custers

et al. 2020

European Journal of Surgical Oncology

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Follow-up after curative treatment for colorectal cancer (CRC) puts pressure on outpatient services due to the growing number of CRC survivors. The aim of this state-of-the-art review was to evaluate setting, manner and provider of follow-up. Moreover, perceptions of CRC survivors and health care providers regarding standard and alternative follow-up were examined. After a comprehensive literature search of the PubMed database, 69 articles were included reporting on CRC follow-up in the hospital, primary care and home setting. Hospital-based follow-up is most common and has been provided by surgeons, medical oncologists, and gastroenterologists, as well as nurses. Primary care-based follow-up has been provided by general practitioners or nurses. Even though most hospital-or primary care-based follow-up care requires patients to visit the clinic, telephone-based care has proven to be a feasible alternative. Most patients perceived follow-up as positive; valuing screening and detection for disease recurrence and appreciating support for physical and psychosocial symptoms. Hospital-based follow-up performed by the medical specialist or nurse is highly preferred by patients and health care providers. However, willingness of both patients and health care providers for alternative, primary care or remote follow-up exists. Nurse-led and GP-led follow-up have proven to be cost-effective alternatives compared to specialist-led follow-up. If proven safe and acceptable, remote follow-up can become a cost-effective alternative. To decrease the personal and financial burden of follow-up for a growing number of colorectal cancer survivors, a more acceptable, flexible and dynamic care follow-up mode consisting of enhanced communication and role definitions among clinicians is warranted.

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Section: Ongoing Studiesmentioning

confidence: 99%

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Qaderi

Swartjes

Custers

et al. 2020

European Journal of Surgical Oncology

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“…This concept has recently been tested in a large, randomized trial following rectal cancer surgery (FURCA trial) where all patients were offered a standard CT scan at 1 and 3 years and were randomized to an initial patient education session combined with open access to the clinic versus standard clinical visits five times over 2 years [9]. The interim analysis does suggest that selected outcomes improve in the experimental arm, where patients report greater involvement and satisfaction with follow‐up care, and less fear of recurrence after 1 year of follow‐up, compared to patients following the standard clinical follow‐up programme.…”

Section: Suggestions For a New Practicementioning

confidence: 99%

“…For the patients, it is crucial that they get a chance to speak to their surgeon and ask specific questions. This concept has recently been tested in a large, randomized trial following rectal cancer surgery (FURCA trial) where all patients were offered a standard CT scan at 1 and 3 years and were randomized to an initial patient education session combined with open access to the clinic versus standard clinical visits five times over 2 years [9].…”

Section: Optimization Of Standard Follow-upmentioning

confidence: 99%

Time for a paradigm shift in the follow‐up of colorectal cancer

et al. 2020

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The aim of follow-up after treatment for colorectal cancer (CRC) is twofold. For the individual patients, the aim is to detect and treat recurrence and sequelae. However, for the healthcare professional, an equally important aim is to follow the general standard of care (morbidity, early and late mortality, sequelae etc.); to understand the consequences of changing practice (robotic surgery, transanal total mesorectal excision, new drugs etc.

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“…A recent study from Denmark investigated a more patient‐centred follow‐up, with an increased focus on physiological and psychological outcomes. The hypothesis is that patient‐led follow‐up will enable identification and treatment of adverse events and lead to earlier detection of local recurrence .…”

Section: Discussionmentioning

confidence: 99%

Low rate of local recurrence detection by rectoscopy in follow‐up of rectal cancer

et al. 2019

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Aim The main aim of this study was to examine the effectiveness of rectoscopy for detecting local recurrence of rectal cancer in patients following low anterior resection. Method This was a retrospective study of 201 patients, who underwent low anterior resection for rectal or rectosigmoid cancer between 2007 and 2009 and who were followed up with rigid rectoscopy and imaging. A total of 91 patients were excluded from the analysis for various reasons, leaving 110 patients eligible for analysis. Results A total of 613 rectoscopies were performed, and 48 biopsies taken. Six local recurrences were detected in the 110 patients, three of which were first detected by rectoscopy and three by CT. Two of the local recurrences were detected outside the follow‐up programme because of symptoms: one by rectoscopy and one by CT. Three of 613 (0.5%) rectoscopies led to detection of local recurrence. The sensitivity and specificity of rectoscopy to detect local recurrence was 0.50 and 0.93, respectively. Nineteen distant metastases were detected, and two patients had both local recurrence and distant metastasis. All local recurrences and distant metastases were detected within 48 months of surgery. Conclusion Rigid rectoscopy is poor at detecting local recurrence. Only 3 out of 613 rectoscopies (0.5%) detected local recurrence. Due to extramural growth of some recurrences, the sensitivity is also very low. Based on our results, routine rectoscopy in the surveillance of asymptomatic patients cannot be recommended.

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Follow-up after rectal cancer: developing and testing a novel patient-led follow-up program. Study protocol

Cited by 15 publications

References 16 publications

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review

Time for a paradigm shift in the follow‐up of colorectal cancer

Low rate of local recurrence detection by rectoscopy in follow‐up of rectal cancer

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