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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2010

01-10-2010 | Colorectal Cancer

Inadequate Quality of Surveillance after Curative Surgery for Colon Cancer

Authors: Carsten T. Viehl, MD, Alex Ochsner, MD, Urs von Holzen, MD, Ramona Cecini, MD, Igor Langer, MD, Ulrich Guller, MD, MHS, Urban Laffer, MD, Daniel Oertli, MD, Markus Zuber, MD

Published in: Annals of Surgical Oncology | Issue 10/2010

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Abstract

Background

Colon cancer patients are at risk for recurrence. Recurrent disease might be curable if detected early by surveillance. However, data on the quality of surveillance are scarce. The objective of this study is to analyze the quality of surveillance after curative surgery for colon cancer among a cohort of Swiss patients.

Patients and Methods

After curative surgery, 129 stage I–III colon cancer patients were followed by chart review, questionnaires, and phone interviews. National surveillance guidelines mandate periodic measurement of carcinoembryonic antigen (CEA) levels, abdominal ultrasound or computed tomography (US/CT), and colonoscopy. However, surveillance was left to the discretion of the treating physicians. Actual surveillance was compared with the recommendations in the guidelines.

Results

Datasets of all 129 patients were available. Median follow-up was 33.5 months (range 5.6–74.7 months). Eighteen patients (14.0%) recurred during follow-up. Three-year overall and disease-free survival were 94.7% and 83.5%, respectively. Periodic CEA measurements, US/CT, and colonoscopies as recommended by the guidelines were performed in 32.8%, 31.7%, and 23.8% of patients, respectively. Forty-four patients (34.1%) received adjuvant chemotherapy. For these patients there was a trend towards better compliance with national surveillance guidelines than for patients without adjuvant chemotherapy.

Conclusions

The quality of surveillance after curative surgery for colon cancer among a cohort of Swiss patients is inadequate. Further education of health care professionals and patients regarding the potential life-saving benefits of surveillance is imperative. It is cardinal that quality of surveillance is critically analyzed in other countries with different health care systems as well.
Literature
1.
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005; 55:74–108.CrossRefPubMed
2.
3.
Bohm B, Schwenk W, Hucke HP, Stock W. Does methodic long-term follow-up affect survival after curative resection of colorectal carcinoma? Dis Colon Rectum. 1993;36:280–6.CrossRefPubMed
4.
Prandi M, Lionetto R, Bini A, et al. Prognostic evaluation of stage B colon cancer patients is improved by an adequate lymphadenectomy: results of a secondary analysis of a large scale adjuvant trial. Ann Surg. 2002;235:458–63.CrossRefPubMed
5.
Kobayashi H, Mochizuki H, Sugihara K, et al. Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study. Surgery. 2007;141:67–75.CrossRefPubMed
6.
Ovaska JT, Jarvinen HJ, Mecklin JP. The value of a follow-up programme after radical surgery for colorectal carcinoma. Scand J Gastroenterol. 1989;24:416–22.CrossRefPubMed
7.
Renehan AG, Egger M, Saunders MP, O’Dwyer ST. Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. BMJ. 2002;324:813.CrossRefPubMed
8.
Jeffrey M, Hickey BE, Hider PN. Follow-up strategies for patients treated for non-metastatic colorectal cancer. Cochrane Database Syst Rev. 2007:CD002200.
9.
Figueredo A, Rumble RB, Maroun J, et al. Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer. 2003;3:26–0.CrossRefPubMed
10.
Grossmann EM, Johnson FE, Virgo KS, Longo WE, Fossati R. Follow-up of colorectal cancer patients after resection with curative intent-the GILDA trial. Surg Oncol. 2004;13:119–24.CrossRefPubMed
11.
Johnson FE, Virgo KS, Fossati R. Follow-up for patients with colorectal cancer after curative-intent primary treatment. J Clin Oncol. 2004;22:1363–5.CrossRefPubMed
12.
Criblez D. Revidierte Konsensus-Empfehlungen zur Nachsorge nach koloskopischer Polypektomie und nach kurativ operiertem kolorektalem Karzinom. Schweiz Med Forum. 2007;7:994–99.
13.
Desch CE, Benson AB, III, Somerfield MR, et al. Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol. 2005;23:8512–9.CrossRefPubMed
14.
Schmiegel W, Adler G, Fruhmorgen P, et al. Colorectal carcinoma: prevention and early detection in an asymptomatic population-prevention in patients at risk-endoscopic diagnosis, therapy and after-care of polyps and carcinomas. German Society of Digestive and Metabolic Diseases/Study Group for Gastrointestinal Oncology. Z Gastroenterol. 2000;38:49–75.CrossRefPubMed
15.
Abdalla EK, Vauthey JN, Ellis LM, et al. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg. 2004;239:818–25; discussion 25–7.CrossRefPubMed
16.
Cummings LC, Payes JD, Cooper GS. Survival after hepatic resection in metastatic colorectal cancer: a population-based study. Cancer. 2007;109:718–26.CrossRefPubMed
17.
Fernandez FG, Drebin JA, Linehan DC, Dehdashti F, Siegel BA, Strasberg SM. Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose (FDG-PET). Ann Surg. 2004;240:438–47; discussion 47–50.CrossRefPubMed
18.
Adam R, Delvart V, Pascal G, et al. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg. 2004;240:644–57; discussion 57–8.CrossRefPubMed
19.
Giacchetti S, Itzhaki M, Gruia G, et al. Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery. Ann Oncol. 1999;10:663–9.CrossRefPubMed
20.
Criblez D. Die revidierten FAGAS-Empfehlungen zur Nachsorge nach koloskopischer Polypektomie und kurativ operiertem kolorektalem Karzinom. Schweiz Med Forum. 2004;4:611–17.
21.
FAGAS. Nachsorge nach Resektion von kolorektalen Polypen und von kolorektalen Karzinomen. Schweizerische Ärztezeitung. 2001;82:1967–71.
22.
Viehl CT, Guller U, Cecini R, et al. Upstaging due to sentinel lymph node procedure in colon cancer—a prospective multicenter study. Ann Surg Oncol. 2008;15:58–59.
23.
Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M. American Joint Committee Cancer Staging Manual. 6th ed. New York: Springer; 2002.
24.
Mulder SA, Van Leerdam ME, Ouwendijk RJ, Bac DJ, Giard RW, Kuipers EJ. Attendance at surveillance endoscopy of patients with adenoma or colorectal cancer. Scand J Gastroenterol. 2007;42:66–71.CrossRefPubMed
25.
Cooper GS, Yuan Z, Chak A, Rimm AA. Patterns of endoscopic follow-up after surgery for nonmetastatic colorectal cancer. Gastrointest Endosc. 2000;52:33–8.CrossRefPubMed
26.
Elston Lafata J, Simpkins J, Schultz L, et al. Routine surveillance care after cancer treatment with curative intent. Med Care. 2005;43:592–9.CrossRefPubMed
27.
Harewood GC, Rathore O, Patchett S, Murray F. Assessment of adherence to published surveillance guidelines—opportunity to enhance efficiency of endoscopic practice. Ir Med J. 2008;101:248–50.PubMed
28.
Kahi CJ, Rex DK, Imperiale TF. Screening, surveillance, and primary prevention for colorectal cancer: a review of the recent literature. Gastroenterology. 2008;135:380–99.CrossRefPubMed
29.
30.
31.
Herzlinger RE, Parsa-Parsi R. Consumer-driven health care: lessons from Switzerland. JAMA. 2004;292:1213–20.CrossRefPubMed
32.
Johnson FE, Novell LA, Coplin MA, Longo WE, Vernava AM, Wade TP, et al. How practice patterns in colon cancer patient follow-up are affected by surgeon age. Surg Oncol. 1996;5:127–31.CrossRefPubMed
33.
Zbidi I, Hazazi R, Niv Y, Birkenfeld S. Colonosopy screening and surveillance of colorectal cancer and polyps: physicians’ knowledge. Isr Med Assoc J. 2007;9:862–5.PubMed
34.
Virgo KS, Wade TP, Longo WE, Coplin MA, Vernava AM, Johnson FE. Surveillance after curative colon cancer resection: practice patterns of surgical subspecialists. Ann Surg Oncol. 1995;2:472–82.CrossRefPubMed
35.
Johnson FE, Longo WE, Ode K, et al. Patient surveillance after curative-intent surgery for rectal cancer. Int J Oncol. 2005;27:815–22.PubMed
36.
Vernava AM III, Longo WE, Virgo KS, Coplin MA, Wade TP, Johnson FE. Current follow-up strategies after resection of colon cancer. Results of a survey of members of the American Society of Colon and Rectal Surgeons. Dis Colon Rectum. 1994;37:573–83.CrossRefPubMed
Metadata
Title
Inadequate Quality of Surveillance after Curative Surgery for Colon Cancer
Authors
Carsten T. Viehl, MD
Alex Ochsner, MD
Urs von Holzen, MD
Ramona Cecini, MD
Igor Langer, MD
Ulrich Guller, MD, MHS
Urban Laffer, MD
Daniel Oertli, MD
Markus Zuber, MD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1084-2

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