Colorectal cancer follow-up: useful or useless?
Follow-up of surgically treated colorectal cancer patients is not supported by objectively certain data. Despite the thousands of investigations reported in the scientific literature, only six randomized prospective studies and two meta-analysis of randomized studies provide data suggesting clear conclusions. Our review of the literature revealed that intensive colorectal follow-up should be performed even if the long-term survival benefit is small. The timing and investigations conducted in follow-ups diverge. The inconsistency of follow-ups is revealed by the fact that the leading USA and European societies propose different guidelines. One datum that the literature agrees on is that pancolonoscopy performed at 3-5 year intervals in colorectal cancer surgery patients supports diagnosis of adenomatous polyps and metachronous cancers. Cost analysis have shown that intensive follow-up would certainly exceed the cut-off point level set for every additional year of good quality of life.
Li Destri
Giovanni
G
Department of Surgical Sciences, Organ Transplantations and Advanced Technologies, University of Catania, Via Santa Sofia 86 95123, Catania, Italy. g.lidestri@unict.it
Di Cataldo
Antonio
A
Puleo
Stefano
S
D002272:Carcinoembryonic Antigen / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D009362:Neoplasm Metastasis; D012008:Recurrence; D016019:Survival Analysis; D016896:Treatment Outcome
D002272:Carcinoembryonic Antigen