Five-year follow-up after radical surgery for colorectal cancer. Results of a prospective randomized trial.
OBJECTIVE
To determine whether an intensified follow-up of patients with colorectal cancer can lead to improved reresectability and a better long-term survival.


METHODS
A prospective randomized trial of 106 patients.


METHODS
Oulu University Hospital, a referral center in northern Finland.


METHODS
A total of 106 consecutive patients who underwent radical resection for colorectal cancer, 54 of whom were randomized into a conventional follow-up group and 52 into an intensified follow-up group.


METHODS
After a 5-year follow-up, the time of detection of recurrence, the recurrence rates, the first method showing recurrence, the mode of recurrence, reresectability, and survival were compared between the groups.


RESULTS
The recurrences were identified earlier in the intensified follow-up group than in the conventional follow-up group (mean +/- SD, 10 +/- 5 months vs 15 +/- 10 months). The overall recurrence rate was 41%, with 39% in the conventional group and 42% in the intensified group. Carcinoembryonic antigen determination was the most common method showing recurrence in both groups. Endoscopy and ultrasound were beneficial in the intensified follow-up group, but computed tomography failed to improve the diagnostics. The mode of recurrence did not differ between the groups. Radical resections were performed on 19% (8/43) of the patients, 14% (3/21) in the conventional group and 22% (5/22) in the intensified group. The cumulative 5-year survival was 54% in the conventional group and 59% in the intensified group.


CONCLUSIONS
Earlier detection of recurrent colorectal cancer by intensified follow-up does not lead to either significantly increased reresectability or improved 5-year survival.
Mäkelä
J T
JT
Department of Surgery, Oulu University Hospital, Finland.
Laitinen
S O
SO
Kairaluoma
M I
MI
D000008:Abdominal Neoplasms / Q000175:diagnosis; D000236:Adenoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002272:Carcinoembryonic Antigen / Q000032:analysis; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D009367:Neoplasm Staging; D011446:Prospective Studies; D012086:Reoperation; D012812:Sigmoidoscopy; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D002272:Carcinoembryonic Antigen