Benefits of colonoscopic surveillance after curative resection of colorectal cancer.
OBJECTIVE
The authors determined the usefulness of routine colonoscopy after colorectal cancer surgery.


BACKGROUND
Some studies suggest benefit to colonoscopy in the routine follow-up of patients with colorectal cancer who are resected for cure, whereas other studies show no benefit.


METHODS
Chart review was conducted for 290 patients who underwent curative resection for colorectal cancer between 1967 and 1991 at a colorectal surgeon's practice. Colonoscopy was performed every 6 months during the first year, then every 1 to 2 years, or when intercurrent symptoms appeared.


RESULTS
Overall, 31 patients (10.7%) developed recurrent disease, which increased as a function of stage (C2 > B2 > A), with a median time to diagnosis of 20 months. Of these 31 recurrences, 14 (45.2%) were solely local (of whom 12 were asymptomatic); 17 (54.8%) involved distant disease. Nine locally recurrent patients were able to undergo curative resection. Of 19 symptomatic patients, only 3 (15.8%) were amenable to curative resection. Six patients (2.1%) developed a metachronous second primary colorectal cancer, of whom four (66.7%) were asymptomatic, and five (83.3%) were able to undergo curative resection. Overall, because of surveillance colonoscopies, 13 asymptomatic patients (4.5%) had curative resection for localized recurrent disease or a metachronous second primary cancer.


CONCLUSIONS
Colonoscopy is a useful modality in the early detection of recurrent and metachronous disease after colorectal cancer, increasing the potential for curative resection and improved survival.
Lautenbach
E
E
Department of Medicine, Columbia University, New York, New York 10032.
Forde
K A
KA
Neugut
A I
AI
D000368:Aged; D000714:Anastomosis, Surgical; D002277:Carcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011159:Population Surveillance; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors