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Cancer du côlon : bilan et surveillance

Colon cancer: assessment and monitoring

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Oncologie

Résumé

On pense intuitivement qu’en surveillant les malades on peut détecter des récidives asymptomatiques accessibles à une résection. Cette surveillance postopératoire des cancers colorectaux (CCR) opérés à visée curative reste mal codifiée en raison du petit nombre d’études randomisées publiées et surtout de leur manque de puissance. Cependant, les études les plus récentes suggèrent malgré leurs limites un gain de survie avec une surveillance clinique associée à une imagerie hépatique et pulmonaire et éventuellement au dosage de l’antigène carcinoembryonique (ACE). Les récidives endoluminales et les cancers métachrones sont rares : c’est la détection des récidives locorégionales et des métastases qui peut permettre d’améliorer la survie.

Abstract

Intuitively, it is assumed that by monitoring patients it is possible to detect resectable asymptomatic relapses. This curative post-operative follow-up of colorectal cancer surgery remains poorly validated due to the small number of published randomised studies and in particular their lack of statistical power. However, the most recent studies suggest that, in spite of their limitations, an increase in survival is seen with clinical follow-up combined with hepatic and pulmonary imaging and possibly analysis of ACE levels. Intraluminal relapses and metachronous tumours are rare: it is the detection of localised relapses and metastases that will enable improvements in survival.

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  1. Registre bourguignon des cancers digestifs, Inserm U866, université de Bourgogne, CHU de Dijon, 7, boulevard Jeanne-d’Arc, BP 87900, F-21079, Dijon Cedex, France

    A. Drouillard & C. Lepage

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  1. A. Drouillard
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  2. C. Lepage
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Correspondence to C. Lepage.

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Drouillard, A., Lepage, C. Cancer du côlon : bilan et surveillance. Oncologie 16, 517–524 (2014). https://doi.org/10.1007/s10269-014-2471-2

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  • DOI: https://doi.org/10.1007/s10269-014-2471-2

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