ABSTRACT
BACKGROUND: The purpose of this study is to present the experience of our department regarding the importance of the systematic postoperative follow-up of patients with colorectal cancer, early diagnosis and treatment of the recurrence of the disease or a metachronous cancer. METHODS: In a study that took place between October 2001 and February 2004 amongst 67 patients that were operated upon for colorectal cancer, 41 were systematically being followed up through CT scan, colonoscopy and tumour markers. RESULTS: In the 14th and 18th months postoperatively for 2 of the patients the CT scan showed hepatic metastasis, while the colonoscopy was negative. Regarding the tumour markers, one (CEA) was elevated in one patient while three were elevated in the others. For 2 out of the 41 patients the colonoscopy showed recurrence of the disease within one and two years respectively. The CT scan proved to be free of metastasis and the tumour markers were falling within the normal range for one of the patients while for the other CEA was elevated. Both patients underwent additional colectomy. Postoperative increase of the tumour markers was observed in 9 patients. The above patients had normal markers in the immediate postoperative period. For 4 out of the 9 patients recurrence or spread of the disease was observed while the rest of them are still being followed up. CONCLUSIONS: In conclusion, we believe that the systematic postoperative follow-up of the patients with colorectal cancer through CT, colonoscopy and the use of tumour markers contributes decisively to the early diagnosis and treatment of any possible recurrence of the cancer or a metachronous cancer or misdiagnosed concomitant cancer.
Subject(s)
Biomarkers, Tumor/blood , Colectomy/adverse effects , Colorectal Neoplasms/pathology , Colorectal Neoplasms/surgery , Monitoring, Physiologic/methods , Postoperative Complications/diagnosis , Adult , Aged , Cohort Studies , Colectomy/methods , Colonoscopy/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Staging , Postoperative Care/methods , Prospective Studies , Risk Assessment , Sensitivity and Specificity , Survival Analysis , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
BACKGROUND: The purpose of our study is to emphasise the diagnostic and therapeutic problems of metachronous colorectal cancer. MATERIALS AND METHODS: Between 1990 and February 2004, amongst 185 patients that were treated for colorectal cancer, in four of them a metachronous carcinoma was diagnosed. RESULTS: 1st patient: male 41 years, underwent colectomy of the descending colon for adenocarcinoma. Four years later, a rectosigmoidal cancer was found infiltrating urinary bladder. 2nd patient: male 62 years, underwent right hemicolectomy. Eight years later two synchronous cancers were diagnosed, in the left colic flexure and in the sigmoid colon. 3rd patient: female 73 years, underwent low anterior resection for rectal cancer. Eight years later, caecal and ascending colon cancers were diagnosed with hepatic metastases. 4th patient: female 60 years underwent transversectomy. Six years later caecal cancer was diagnosed with pulmonary metastases. Amongst the four patients, only the fourth had an adequate postoperative follow up. CONCLUSIONS: Extended radical colectomies in young patients and in those where adenomatous polyps coexist will reduce the incidence of metachronous carcinoma. Effective and persistent postoperative surveillance in patients with colorectal cancer will greatly contribute in the detection and treatment of metachronous carcinomas.
