Investigation, follow-up and recurrence after resection of colorectal cancer.
A study was undertaken to determine the patterns of management in the 2 years following resection of colorectal cancer by Victorian surgeons. Patients were identified by the Victorian Cancer Register as having colorectal cancer diagnosed between July 1 and December 31 1987. The surgeon of each of the 947 eligible patients who underwent surgery was sent a questionnaire seeking information about the pre-operative investigation, type of surgery and subsequent line of referral. Only 16% of colonic cancers and 39% of rectal cancers were biopsied pre-operatively and colonoscopy was undertaken in one-half and one-third respectively. Of the 737 responses, 555 patients were considered to have had curative surgery, and details of their follow-up during the four 6-month periods following surgery was analysed; this includes the effect of tumour stage and surgeon activity on the use and frequency of each test. Most patients had a clinical examination in each of the 6 month periods, but almost half did not have a colonoscopy and two-thirds did not have the serum CEA level measured at all. Only one in eight had a chest X-ray and fewer had the liver scanned during this 2 year period. Eighty-two patients (20% of those satisfactorily followed) suffered a recurrence during this period. Twenty-six were asymptomatic at the time of recurrence and were diagnosed by a routine test and of these, eight were diagnosed by tests used infrequently. Sixteen (20%) were considered surgically curable.
McLeish
J A
JA
Gastrointestinal Study Group, Anti-Cancer Council of Victoria, Melbourne, Australia.
Giles
G G
GG
Thursfield
V
V
D000359:Aftercare / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data; D002272:Carcinoembryonic Antigen / Q000097:blood; D003082:Colectomy / Q000379:methods / Q000706:statistics & numerical data; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D003663:Decision Trees; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010808:Physical Examination / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012042:Registries; D011795:Surveys and Questionnaires; D015996:Survival Rate; D014739:Victoria / Q000453:epidemiology
D002272:Carcinoembryonic Antigen