Postoperative follow-up of patients with colorectal cancer: a combined evaluation of CT scan, colonoscopy and tumour markers.
BACKGROUND
The purpose of this study is to present the experience of our department regarding the importance of the systematic postoperative follow-up of patients with colorectal cancer, early diagnosis and treatment of the recurrence of the disease or a metachronous cancer.


METHODS
In a study that took place between October 2001 and February 2004 amongst 67 patients that were operated upon for colorectal cancer, 41 were systematically being followed up through CT scan, colonoscopy and tumour markers.


RESULTS
In the 14th and 18th months postoperatively for 2 of the patients the CT scan showed hepatic metastasis, while the colonoscopy was negative. Regarding the tumour markers, one (CEA) was elevated in one patient while three were elevated in the others. For 2 out of the 41 patients the colonoscopy showed recurrence of the disease within one and two years respectively. The CT scan proved to be free of metastasis and the tumour markers were falling within the normal range for one of the patients while for the other CEA was elevated. Both patients underwent additional colectomy. Postoperative increase of the tumour markers was observed in 9 patients. The above patients had normal markers in the immediate postoperative period. For 4 out of the 9 patients recurrence or spread of the disease was observed while the rest of them are still being followed up.


CONCLUSIONS
In conclusion, we believe that the systematic postoperative follow-up of the patients with colorectal cancer through CT, colonoscopy and the use of tumour markers contributes decisively to the early diagnosis and treatment of any possible recurrence of the cancer or a metachronous cancer or misdiagnosed concomitant cancer.
Ntinas
A
A
5th Surgical Clinic, Aristotle University, Ippokratio General Peripheral Hospital, 49 Kostantinoupoleos Str., 546 42 Thessaloniki, Greece.
Zambas
N
N
Al Mogrambi
S
S
Petras
P
P
Chalvatzoulis
E
E
Frangandreas
G
G
Tsantilas
D
D
Spiridis
C
C
Gerasimidis
T
T
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D014408:Biomarkers, Tumor