Abstract
Close surveillance of colorectal cancer (CRC) patients is helpful as early detection of resectable metastasis has a survival benefit. Ultrasonography (USG) is a frequently used modality to detect liver recurrence, although international guidelines do not include it. To evaluate the potential added role of USG in early detection of CRC recurrence. We performed a retrospective analysis of 230 patients of colorectal cancer treated at our institute in 2013–2014 who underwent abdominal USG for surveillance. 77/230 (33%) developed recurrence, with liver being the second most common site (22/230). 5/230 (2%) patients had recurrent disease first detected on USG, four of which also had raised serum CEA (carcinoembryonic antigen) levels. There were three false positive and four false-negative cases on USG. There was no added advantage of USG for early detection of CRC recurrence.
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Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386
Kjeldsen BJ, Kronborg O, Fenger C, Jorgensen OD (1997) The pattern of recurrent colorectal cancer in a prospective randomized study and the characteristics of diagnostic tests. Int J Color Dis 12:329–334
Steele SR, Chang GJ, Hendren S, Weiser M, Irani J, Buie WD, Janice F (2015) Rafferty practice guideline for the surveillance of patients after curative treatment of colon and rectal cancer. MD Dis Colon Rectum 58:713–725. https://doi.org/10.1097/DCR.0000000000000410
Walker AS, Johnson EK, Maykel JA, Stojadinovic A, Nissan A, Brucher B, Steele SR (2014) Future directions for the early detection of colorectal cancer recurrence. J Cancer 5:272–280. https://doi.org/10.7150/jca.8871
A S, Auer RA (2010) Surveillance after curative resection of colorectal cancer. Radiol Oncol 44:135–141. https://doi.org/10.2478/v10019-010-0018-8
Galandiuk S, Wieand HS, Moertel CG, Cha SS, Fitzgibbons RJ Jr, Pemberton JH, Wolff BG (1992) Patterns of recurrence after curative resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 174:27–32
Fernandez FG, Drebin JA, Linehan DC, Dehdashti F, Siegel BA, Strasberg SM (2004) 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 240:438–450. https://doi.org/10.1097/01.sla.0000138076.72547.b1
Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg 84:324–338
Viganò L, Ferrero A, Lo Tesoriere R, Capussotti L (2008) Liver surgery for colorectal metastases: results after 10 years of follow-up. Long-term survivors, late recurrences, and prognostic role of morbidity. Ann Surg Oncol 15:2458–2464
NCCN guidelines for colorectal cancer Available from https://www.nccn.org/professionals/physician_gls/pdf/colon_blocks.pdf. Accessed on 2018 April 09
Follow-Up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement. Available from https://www.asco.org/practice-guidelines/quality-guidelines/guidelines/gastrointestinal-cancer#/10246. Accessed on 2018 May 10
Available from. http://www.esmo.org/Guidelines/Gastrointestinal-Cancers/Management-of-patients-with-colon-and-rectal-cancer.-A-personalized-approach-to-clinical-decision-making. Accessed on 2018 May 14
Consensus document for management of colorectal cancer. http://icmr.nic.in/guide/cancer/Colorectal/Colorectal%20Cancer.pdf. Accessed on 2018 April 14
Labianca R, Nordlinger B, Beretta GD, Mosconi S, Mandalà M, Cervantes A, Arnold D, ESMO Guidelines Working Group (2013) ESMO clinical practice guidelines for diagnosis, treatment and follow up. Ann Oncol 24:vi64–vi72
Patil PS, Saklani A, Gambhire P, Mehta S, Engineer R, De’Souza A, Chopra, Bal M. Colorectal cancer in India: an audit from a tertiary center in a low prevalence area
Vaneja Velenik. Post-treatment surveillance in colorectal cancer. PMCID: PMC3423699
Broadbridge VT, Karapetis CS, Beeke C, Woodman RJ, Padbury R, Maddern G, Kim SW, Roder D, Hakendor P, Price TJ (2013) Do metastatic colorectal cancer patients who present with late relapse after curative surgery have a better survival? Br J Cancer 109:1338–1343. https://doi.org/10.1038/bjc.2013.388
Bengmark S, Hafstrom L (1969) The natural history of primary and secondary malignant tumors of the liver. I. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy. Cancer 23:198–202
Ohlsson B, Stenram U, Tranberg KG (1998) Resection of colorectal liver metastases: 25-year experience. World J Surg 22:268–277
Saito G, Sadahiro S, Kamata H, Miyakita H, Okada K, Tanaka A, Suzuki T (2017) Monitoring of serum carcinoembryonic antigen levels after curative resection of colon cancer: cutoff values determined according to preoperative levels enhance the diagnostic accuracy for recurrence. Oncology 92:276–282. https://doi.org/10.1159/000456075
Chau I, Allen MJ, Cunningham D, Norman AR, Brown G, Ford HER, Tebbutt N, Tait D, Hill M, Ross PJ, Oates J (2004) The value of routine serum carcino-embryonic antigen measurement and computed tomography in the surveillance of patients after adjuvant chemotherapy for colorectal cancer. J Clin Oncol 22:1420–1429
Sørensen CG, Karlsson WK, Pommergaard HC, Burcharth J, Rosenberg J (2016) The diagnostic accuracy of carcinoembryonic antigen to detect colorectal cancer recurrence – a systematic review. Int J Surg 25:134–144. https://doi.org/10.1016/j.ijsu.2015.11.065
E A, Navarro M, Parés D, Muñoz M, Pareja L, Figueras J, Soler G, Martinez M, Majem M, Germa-Lluch JR (2006) Imaging techniques contribute to increased surgical rescue of relapse in the follow-up of colorectal cancer. Dis Colon Rectum 49:478–484
Primrose JN, Perera R, Gray A, Rose P, Fuller A, Corkhill A, George S, Mant D (2014) Effect of 3 to 5 years of scheduled CEA and CT follow-up to detect recurrence of colorectal cancer: the FACS randomized clinical trial. JAMA 311:263–270
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Suman, G., Baheti, A.D., Ankathi, S.K. et al. Role of Ultrasonography in the Surveillance of Disease-Free Patients with Colorectal Cancer: a Retrospective Audit. Indian J Surg Oncol 9, 452–455 (2018). https://doi.org/10.1007/s13193-018-0815-x
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DOI: https://doi.org/10.1007/s13193-018-0815-x