title: Follow-up after surgical treatment for cancer of the gastrointestinal tract.
abstract: BACKGROUND
  Presently, no evidence-based guidelines for the follow-up of patients after surgery for gastrointestinal cancer are available. As a consequence, follow-up strategies may differ between hospitals depending on preference of physicians. We investigated which follow-up procedures are currently employed after surgery for gastrointestinal cancer in the Netherlands.
  
  
  METHODS
  A questionnaire was sent to all surgical departments in the Netherlands. The questionnaire focused on frequency of follow-up visits and diagnostic procedures after surgical treatment for oesophageal, gastric, pancreatic and colorectal cancer and psychosocial issues during follow-up.
  
  
  RESULTS
  The response rate was 90% (83/92). In the majority of hospitals, surgeons treated patients with colorectal (100%) and gastric (96%) cancer in their own centre, whereas patients with pancreatic (64%) and oesophageal (61%) cancer were more often referred to a tertiary centre. For all patients treated for gastrointestinal cancer, three to four follow-up visits were made in the first year, followed by at least two annual visits thereafter. After colorectal surgery, blood tests (78%), colonoscopy (75%) and abdominal ultrasound (57%) were frequently performed. In other gastrointestinal malignancies, procedures were in most cases only performed if symptoms occurred. In almost three-quarters of patients, psychosocial problems were observed, which were dealt with by surgeons in two-thirds of patients. The majority of patients treated for gastrointestinal cancer were pre- and postoperatively discussed in a multidisciplinary setting. Oncologists, gastroenterologists and dieticians were the most frequently consulted specialists after surgery for gastrointestinal cancer.
  
  
  CONCLUSIONS
  Patients frequently visit the outpatient clinic after surgery for gastrointestinal cancer in the Netherlands. Whereas follow-up after colorectal cancer surgery focuses on finding recurrent disease and metachronous lesions in the colorectum, this is less clear after oesophageal, gastric and pancreatic cancer surgery. Further studies are needed to establish what is the most effective follow-up protocol after different types of gastrointestinal cancer surgery.
authors.affiliation: Department of Gastroenterology & Hepatology, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
authors.forename: E M L
authors.initials: EM
authors.lastname: Verschuur
authors.forename: E W
authors.initials: EW
authors.lastname: Steyerberg
authors.forename: E J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: H W
authors.initials: HW
authors.lastname: Tilanus
authors.forename: P D
authors.initials: PD
authors.lastname: Siersema
mesh_terms: D001772:Blood Cell Count; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000601:surgery* / Q000628:therapy*; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D009426:Netherlands; D010808:Physical Examination; D011795:Surveys and Questionnaires