[Efficacy, impact on survival and cost of intensive follow-up after curative resection for colorectal cancer aim].
OBJECTIVE
This retrospective study was aimed at establishing the efficacy, impact on survival and cost of an intensive follow-up program.


METHODS
Data from 790 patients who underwent resections for primary colorectal carcinoma were prospectively entered into a data-base. Four hundred fifty-six patients who had radical surgery were followed-up with a 5-year preestablished schedule. Median follow-up was 42 months (range 2-108).


RESULTS
Seventy-four adenomas, 7 metachronous carcinomas, 11 extra-colonic carcinomas and 96 recurrences (13 locoregional recurrences, 68 metastases and 15 cases of combined recurrences) were detected. Thirty-eight (39.6%) of 96 recurrences were amenable to salvage therapy and 23 relapses (24.0%) were radically resected. The median survival of patients who had recurrences was 38 months. The 5-year overall survival was significantly better in patients underwent radical surgery than those who were not treated with curative resection (60.0% vs 7.5%, p < 0.0001). Radical re-operations were performed in 2 (4.8%) of the 42 symptomatic patients and in 21 (38.9%) of the 54 cases with asymptomatic relapses. Median overall survival of patients with asymptomatic recurrences was significantly higher than those with syntomatic relapses (20 vs 6 months, p < 0.0001). The follow-up program used showed an efficacy of 4.6% and led to an expense, based on the exclusive cost of the visits and tests included, of 2087,10 Euro for colonic cancer and 2519.90 Euro for rectal cancer.


CONCLUSIONS
Our intensive follow-up program after curative colorectal cancer surgery allowed to detect a quite large number of asymptomatic recurrences with a benefit in term of radical re-operation and overall survival.
Cola
Bruno
B
Clinica Chirurgica II, Dipartimento di Scienze Chirurgiche e Anestesiologiche, Università degli Studi di Bologna. bruno.cola@unibo.it
Cuicchi
Dajana
D
Lecce
Ferdinando
F
Lombardi
Raffaele
R
Ciaroni
Valentina
V
Dalla Via
Barbara
B
D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000191:economics / Q000401:mortality / Q000601:surgery*; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors