Follow-up strategies after curative resection of colorectal cancer.
Consensus is lacking as to the best strategy for following patients who have undergone definitive surgical medical treatment for colon cancer. The goal of any surveillance program should be detection of recurrent disease at a sufficiently early time to allow subsequent curative therapy. Although periodic clinical examinations, laboratory tests, radiographic imaging, and carcinoembryonic antigen (CEA) testing have been utilized as a form of surveillance, such aggressive and costly intervention has not been validated through clinical studies. Four of the five randomized trials comparing such an intensive surveillance strategy to less frequent testing have not demonstrated the intensive approach to lead to an improvement in overall survival. Furthermore, intensive testing is both costly and has been shown not to improve quality of life. Further research designing appropriate postoperative testing is needed to guide physicians and patients after the curative resection of a colorectal cancer.
Meyerhardt
Jeffrey A
JA
Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA.
Mayer
Robert J
RJ
D014408:Biomarkers, Tumor; D019411:Clinical Laboratory Techniques / Q000191:economics; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control / Q000601:surgery; D003266:Continuity of Patient Care / Q000191:economics / Q000592:standards*; D003362:Cost-Benefit Analysis; D003952:Diagnostic Imaging / Q000191:economics; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000592:standards*; D009362:Neoplasm Metastasis / Q000175:diagnosis* / Q000517:prevention & control; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
D014408:Biomarkers, Tumor