[Is it necessary to monitor patients surgically treated for colorectal cancer?].
Survival improvement in patients operated on for colorectal cancer might be the consequence of early diagnosis, rather than improvement in the treatment and follow-up. Therefore the question is: how to follow-up patients operated on for colorectal cancer? And even: is it necessary to follow-up these patients? Follow-up has two intentions, to diagnose metachronous tumors (adenomas and cancers), and to reveal a relapsing disease. However more than a relapse, diagnosis of a "residual" disease is questioned. This residual disease was present after what was thought to be a "curative" treatment, but lack of sensitivity of our diagnosis tools delayed the diagnosis. Follow-up is worthwhile if prognostic of patient treated of their "residual" disease is better when diagnosis is made during this follow-up, rather than when it is postponed until the disease become symptomatic. This has never been proved. Exams which should not be performed anymore are: CA 19-9, liver tests, systematic CT scan (as a diagnosis exam, but CT scan is worthwhile when a curative treatment is expected), systematic repeated colonoscopy. Conclusions on follow-up proposed at a recent consensus conference reached consensus in that it justified exams which effectiveness was never proved....
Millat
B
B
Service de Chirurgie Digestive, Hôpital Saint-Eloi, Montpellier.
Borie
F
F
D018395:CA-19-9 Antigen / Q000032:analysis; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003113:Colonoscopy; D005500:Follow-Up Studies; D006801:Humans; D008111:Liver Function Tests; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D018365:Neoplasm, Residual; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D018395:CA-19-9 Antigen
Faut-il surveiller les malades opérés d'un cancer colorectal?