The Value of Follow-up after Curative Resection for Colorectal Cancer

ABSTRACT

PURPOSE: This study was aimed at determining whether a regular follow-up of patients with colorectal cancer can lead to improved re-resectability, and which test is useful for detecting a resectable recurrence. METHODS: The medical records of 397 consecutive patients, who underwent a curative resection for colorectal cancer between January 1996 and December 2000, with a mean follow-up of 36 months, were retrospectively analysed. RESULTS: The overall recurrence rate was 19.6%, with 22.5% and 7.8% in the regular and irregular follow-up groups (P=0.002), respectively. There was a significant difference in the asymptomatic recurrence detection rate (68.1 vs. 16.7%; P=0.021), but a curative intent reoperation was possible in 21 (29.1%) of those patients with a cancer recurrence in the regular follow-up group, and in 1 (16.7%) inform the irregular follow-up group, which was not significantly different (P= 0.454). Careful history taking and a physical examination were beneficial in the detection of a resectable recurrence. Serum carcinoembryonic antigen determination and endoscopy were useful for detecting a recurrence (14 cases and 5 cases, respectively), and of these 4 (28.6%) and 5 cases (100%) could be treated with a curative intent reoperation, respectively. Abdominal CT, or MRI, and a chest radiography were also useful for detecting a recurrence (22 cases and 8 cases, respectively), but the curative intent reoperation rates were slightly low (3 cases (13.6%) and 1 case (12.5%), respectively). CONCLUSION: A regular follow-up after a curative resection for colorectal cancer, although facilitating detection of recurrence before symptoms developed, was unlikely to succeed in increasing the rate of a curative reoperation.