Small but significant survival benefit in patients who undergo routine follow-up after colorectal cancer surgery.
BACKGROUND
The benefit of follow-up for patients after resection of primary colorectal cancer is unproven. The aim of this study was to evaluate the value of a standardised follow-up program considering detection of recurrent disease, eligibility for surgical treatment and survival.


METHODS
Five hundred and sixty-four patients' records were evaluated. Detection of recurrent disease was distinguished in routine follow up (RF), interval visit (IV) or accidental finding (AF).


RESULTS
One hundred and forty-nine patients (26%) had recurrent disease of which 68 were detected by routine follow-up. In 42 patients a resection was performed with curative intent (RF 18, IV 14, AF 10). In 26 patients radical resection (R(0)) was possible (RF 13, IV 5, AF 8), seven of them were long-term survivors. Routine follow-up itself had no significant influence on overall survival (P=0.08), although increased survival was observed if recurrent disease was detected by routine follow-up and resection was performed with curative intent (P=0.006). Median survival after resection was 4.2 years if recurrent disease was detected during routine follow-up and 0.5 years if detected during interval visits.


CONCLUSIONS
Patients undergoing resection with curative intent for recurrent disease survive significantly longer if the disease is detected by routine follow-up. Routine follow-up itself did not improve overall survival.
Bonthuis
D C
DC
Department of Surgery, Rijnstate Hospital, P.O. Box 9555, 6800 TA Arnhem, The Netherlands.
Landheer
M L E A
ML
Spillenaar Bilgen
E J
EJ
Slootmans
F C W
FC
van Lier
H
H
Klinkenbijl
J H G
JH
Wobbes
Th
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002277:Carcinoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D002423:Cause of Death; D002985:Clinical Protocols; D003082:Colectomy; D003110:Colonic Neoplasms / Q000601:surgery*; D003113:Colonoscopy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D012004:Rectal Neoplasms / Q000601:surgery*; D012086:Reoperation; D015996:Survival Rate
D002272:Carcinoembryonic Antigen