title: Intensive radiographic and biomarker surveillance in stage II and III colorectal cancer.
abstract: OBJECTIVE
  The objective of this study was to determine the rate of salvage resections in patients with stage II and III colorectal cancer following intensive surveillance in a comprehensive cancer center.
  
  
  METHODS
  Patients with stage II and III colorectal cancer with a minimum follow-up of 3 years were included. Carcinoembryonic antigen was obtained every 3 months for 2 years and then every 6 months for years 3-5. CT scans of the chest, abdomen and pelvis were performed every 6 months for 2 years and then yearly for years 3-5. Colonoscopy was performed at year 1 and then every 3 years.
  
  
  RESULTS
  One hundred and seventy-seven patients were followed for a median of 60 months; 44 patients were diagnosed with recurrent disease. CT was the first sign of recurrence in 68% of patients. Carcinoembryonic antigen test was normal in 20 patients (45%) at the time of disease recurrence. Twenty-five patients (57%) with recurrent disease underwent curative-intent resection, 12 of whom are still cancer free at a median follow-up of 81 months.
  
  
  CONCLUSIONS
  In this retrospective study, intensive radiographic screening was associated with a high salvage resection rate, which led to favorable clinical outcomes. Randomized clinical trials are urgently needed to define the optimal duration and schedule of radiographic screening in stage II and III colorectal cancer.
authors.affiliation: Department of Medicine, Roswell Park Cancer Institute, Buffalo, N.Y., USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Fora
authors.forename: Annie
authors.initials: A
authors.lastname: Patta
authors.forename: Kristopher
authors.initials: K
authors.lastname: Attwood
authors.forename: Gregory
authors.initials: G
authors.lastname: Wilding
authors.forename: Marwan
authors.initials: M
authors.lastname: Fakih
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen