Symptomatic and Asymptomatic Colon Cancer Recurrence: A Multicenter Cohort Study

Duineveld, Laura A M; Asselt, Kristel M. van; Bemelman, Willem A.; Smits, Anke B.; Tanis, Pieter J.; Weert, Henk van; Wind, Jan

doi:10.1370/afm.1919

Cited by 97 publications

(70 citation statements)

References 14 publications

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“…The 64 patients (17%) who were diagnosed with RD in our study were mostly detected during scheduled FU and were asymptomatic. The median time until detection was 15 months, which is comparable to the 14 months reported for colon cancer recurrence by our study group [15]. Only 2 patients in this study were diagnosed with RD more than 3 years after surgery -just over 1% of patients with more than 3 years of FU.…”

Section: Discussionsupporting

confidence: 76%

Clinical Pattern of Recurrent Disease during the Follow-Up of Rectal Carcinoma

et al. 2017

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Background/Aims: Several initiatives have started to transfer colorectal cancer follow-up (FU) from secondary to primary care. For this purpose, it is important to assess when and how recurrences of rectal carcinoma are detected after treatment with curative intent. Methods: Retrospective multicentre cohort study. Patients participating in an FU programme after curative intended treatment for rectal cancer stages I-III between 2007 and 2014. Results: Of the 378 patients, 64 (17%) developed recurrent disease (RD). Most were detected during scheduled FU consultations (n = 55) by (a combination of) radiological examinations and carcinoembryonic antigen levels, and were asymptomatic (n = 53); outside scheduled FU consultations, RD was detected during the treatment of postoperative complications or ostomy reversal (n = 5), or due to symptoms (n = 4). Most frequent sites of recurrence were liver (50%), lung (44%), multiple (22%) or locoregional (16%). Treatment of RD with curative intent was performed more frequently when detected during scheduled FU (60 vs. 22%). The only predictive factor for developing RD was stage III disease on initial presentation. Conclusions: The majority of rectal cancer patients are diagnosed with RD at an asymptomatic stage during scheduled FU consultations. Only a few patients presented with RD outside the FU programme. Arguably, general practitioners could order these same diagnostic tests during FU.

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Section: Discussionsupporting

confidence: 76%

Clinical Pattern of Recurrent Disease during the Follow-Up of Rectal Carcinoma

et al. 2017

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“…The association between comorbidity and earlier detection of CR shown in this study may be related to increased healthcare contacts among comorbid patients due to their chronic conditions (Søgaard et al, 2013). Furthermore, 15% of CRs after lung cancer and 42% of CRs after colorectal cancer are detected outside the follow-up programmes (Christensen et al, 2018;Duineveld et al, 2016). The need for more focus on symptom presentation of CR is supported by the fact that the majority of CRs after malignant melanoma and breast cancer are detected outside the follow-up programmes (Francken et al, 2007;Grunfeld et al, 1996).…”

Section: Interpretation and Implicationsmentioning

confidence: 75%

“…The need for more focus on symptom presentation of CR is supported by the fact that the majority of CRs after malignant melanoma and breast cancer are detected outside the follow-up programmes (Francken et al, 2007;Grunfeld et al, 1996). Furthermore, 15% of CRs after lung cancer and 42% of CRs after colorectal cancer are detected outside the follow-up programmes (Christensen et al, 2018;Duineveld et al, 2016).…”

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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“…The report from the hospital caregiver must include: Follow-up of long-term CRC survivors requires good communication between both levels of care to guarantee quick access to treatment in response to any sign of suspected recurrence or a second tumour. The objectives of primary care follow-up should focus on the detection of curable recurrences and second neoplasms, monitoring of the complications of long-term treatments, monitoring of sequelae and comorbidities, and above all, improving the quality of life for these patients [62][63][64]. These aspects should be reflected in the clinical history from the primary care and indicated in the referral report to hospital caregiver if necessary [58].…”

Section: Coordination Between Levels Of Care For Optimal Colorectal Cmentioning

confidence: 99%

Recommendations for follow-up of colorectal cancer survivors

et al. 2019

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Colorectal cancer (CRC) is one of the tumours with the highest incidence and mortality in the Spanish population. Nevertheless, the advances in prevention and treatment have contributed to an increased number of patients who survive for prolonged periods of time. In addition, despite recurrences, improved survival following metastasis resection is likewise on the rise. This underscores the importance of carrying out follow-up programmes even in low-risk patients for the early detection of recurrence. The main objective of this article is to provide a set of recommendations for optimising the follow-up of CRC survivors as well as for managing the sequelae that result from either pharmacological or surgical treatment.

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Symptomatic and Asymptomatic Colon Cancer Recurrence: A Multicenter Cohort Study

Cited by 97 publications

References 14 publications

Clinical Pattern of Recurrent Disease during the Follow-Up of Rectal Carcinoma

Clinical Pattern of Recurrent Disease during the Follow-Up of Rectal Carcinoma

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

Recommendations for follow-up of colorectal cancer survivors

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