Abstract
Background
This study aimed to determine the diagnostic yield of colonoscopy 1 year after colorectal cancer (CRC) resection based on whether the index colonoscopy was performed by the operating surgeon.
Methods
All patients undergoing surgery for colorectal cancer by two colon and rectal surgeons at a university hospital from 1991 to 2005 were identified from the tumor registry. Those patients with a complete preoperative colonoscopy by any physician and a 1-year follow-up examination by the operating surgeon were selected for the study population. Family history of colorectal cancer, tumor location, endoscopist, presence of synchronous neoplasms, and findings of 1-year colonoscopy were recorded. Fisher’s exact test was used to compare the probability of finding any adenoma, advanced adenoma, or invasive cancer based on the index endoscopist.
Results
Of the 719 patients who underwent resection during the study period, 432 met the inclusion criteria. The index colonoscopy for 117 of these patients (27.1%) was performed by one of the two surgeons. Overall, 10 patients (2.3%) had a “new” cancer diagnosed at 1 year, and 1 patient (0.2%) had a local recurrence. Patients whose index colonoscopy was performed by their operating surgeon appeared less likely to have an advanced lesion found at 1 year (5.1% vs 11.4%; p = 0.06). The index colonoscopy for 9 of the 10 of cancers found at 1 year was not performed by the operating surgeon.
Conclusions
Colonoscopy 1 year after CRC resection is clearly justified. An index colonoscopy by the operating surgeon eliminates a “handoff” and may diminish the incidence of high-risk lesions at 1 year.
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References
Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF (1993) Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med 329:1977–1981
Green RJ, Metlay JP, Propert K, Catalano PJ, Macdonald JS, Mayer RJ, Haller DG (2002) Surveillance for second primary colorectal cancer after adjuvant chemotherapy: an analysis of Intergroup 0089. Ann Intern Med 136:261–269
Rulyak SJ, Lieberman DA, Wagner EH, Mandelson MT (2007) Outcome of follow-up colon examination among a population-based cohort of colorectal cancer patients. Clin Gastroenterol Hepatol 5:470–476
Lieberman DA, Weiss DG, Harford WV, Ahnen DJ, Provenzale D, Sontag SJ, Schnell TG, Chejfec G, Campbell DR, Kidao J, Bond JH, Nelson DB, Triadafilopoulos G, Ramirez FC, Collins JF, Johnston TK, McQuaid KR, Garewal H, Sampliner RE, Esquivel R, Robertson D (2007) Five-year colon surveillance after screening colonoscopy. Gastroenterology 133:1077–1085
Rex DK, Kahi CJ, Levin B, Smith RA, Bond JH, Brooks D, Burt RW, Byers T, Fletcher RH, Hyman N, Johnson D, Kirk L, Lieberman DA, Levin TR, O’Brien MJ, Simmang C, Thorson AG, Winawer SJ (2006) Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology 130:1865–1871
Kahi CJ, Rex DK, Imperiale TF (2008) Screening, surveillance, and primary prevention for colorectal cancer: a review of the recent literature. Gastroenterology 135:380–399
Barillari P, Ramacciato G, Manetti G, Bovino A, Sammartino P, Stipa V (1996) Surveillance of colorectal cancer: effectiveness of early patients treated for cure. Dis Colon Rectum 39:388–393
Khoury DA, Opeika FG, Beck DE, Hicks TC, Timmcke AE, Gathright JB Jr (1996) Colon surveillance after colorectal cancer surgery. Dis Colon Rectum 39:252–256
Obrand DI, Gordon PH (1997) Incidence and patterns of recurrence following curative resection for colorectal carcinoma. Dis Colon Rectum 40:15–24
Schoemaker D, Black R, Giles L, Toouli J (1998) Yearly colonoscopy, liver CT, and chest radiography do not influence 5-year survival or colorectal cancer patients. Gastroenterology 114:7–14
Togashi K, Konishi F, Ozawwa A, Sato T, Shito K, Kashiwagi H, Okada M, Nagai H (2000) Predictive factors for detecting colorectal carcinomas in surveillance colonoscopy after colorectal cancer surgery. Dis Colon Rectum 43:S47–S53
Renehan AG, Egger M, Saunders MP, O’Dwyer ST (2002) Impact on survival of intensive follow-up after curative resection for colorectal cancer: systematic review and meta-analysis of randomized trials. Br Med J 324:813
Cali RL, Pitsch RM, Thorson AG, Watson P, Tapia P, Blatchford GJ, Christensen MA (1993) Cumulative incidence of metachronous colorectal cancer. Dis Colon Rectum 36:388–393
Baxter NN, Goldwasser MA, Paszat LF, Saskin R, Urbach DR, Rabeneck L (2009) Association of colonoscopy and death from colorectal cancer: a population-based case-control study. Ann Intern Med 150:1–8
Piscatelli N, Hyman N, Osler T (2005) Localizing colorectal cancer by colonoscopy: are we missing the boat? Arch Surg 140:932–935
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Hyman, N., Moore, J., Cataldo, P. et al. The high yield of 1-year colonoscopy after resection: is it the handoff?. Surg Endosc 24, 648–652 (2010). https://doi.org/10.1007/s00464-009-0660-7
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DOI: https://doi.org/10.1007/s00464-009-0660-7