Abstract
Follow-up and surveillance form an important aspect of care in patients with colorectal cancers (CRC). Most recurrences will occur within 2 years of surgery and 90% by 5 years. Follow up protocols have not been well defined in stage I disease and the approach should be individualized. As 40% of patients with stages II and III will develop recurrences, intensive postoperative follow-up strategy is recommended for them. It includes visit to the clinician for clinical examination, serum carcinoembryonic antigen (CEA), computed tomography (CT) of the chest and abdomen, colonoscopy, and flexible proctosigmoidoscopy in rectal cancers. Surveillance should be undertaken in those who are medically fit for repeat surgical procedures or for chemoradiotherapy. The concept of intensive post operative surveillance is based on the fact that some of these patients can have resectable/curable recurrence.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Goldberg RM, Fleming TR, Tangen CM et al (1998) Surgery for recurrent colon cancer: strategies for identifying resectable recurrence and success rates after resection. Eastern cooperative oncology group, the north central cancer treatment group, and the southwest oncology group. Ann Intern Med 129:27
Quentmeier A, Schlag P, Smok M, Herfarth C (1990) Reoperation for recurrent colorectal cancer: the importance of early diagnosis for resectability and survival. Eur J Surg Oncol 16:319
Ovaska J, Järvinen H, Kujari H et al (1990) Follow up of patients operated on for colorectal carcinoma. Am J Surg 159:593
Pita Fernández S, AlhayekAí M, GonzálezMartín C et al (2015) Intensive follow-up strategies improve outcomes in nonmetastatic colorectal cancer patients after curative surgery: a systematic review and meta-analysis. Ann Oncol 26:644
Graham RA, Wang S, Catalano PJ, Haller DG (1998) Postsurgical surveillance of colon cancer: preliminary cost analysis of physician examination, carcinoembryonic antigen testing, chest xray, and colonoscopy. Ann Surg 228:59
Ohlsson B, Breland U, Ekberg H et al (1995) Follow-up after curative surgery for colorectal carcinoma. Randomized comparison with no follow-up. Dis Colon rectum 38:619
Mäkelä JT, Laitinen SO, Kairaluoma MI (1995) Five year follow-up after radical surgery for colorectal cancer. Results of a prospective randomized trial. Arch Surg 130:1062
Kjeldsen BJ, Kronborg O, Fenger C, Jørgensen OD (1997) A prospective randomized study of followup after radical surgery for colorectal cancer. Br J Surg 84:666
Schoemaker D, Black R, Giles L, Toouli J (1998) Yearly colonoscopy, liver CT, and chest radiography do not influence 5year survival of colorectal cancer patients. Gastroenterology 114:7
RodríguezMoranta F, Saló J, Arcusa A et al (2006) Postoperative surveillance in patients with colorectal cancer who have undergone curative resection: a prospective, multicenter, randomized, controlled trial. J Clin Oncol 24:386
Wang T, Cui Y, Huang WS et al (2009) The role of postoperative colonoscopic surveillance after radical surgery for colorectal cancer: a prospective, randomized clinical study. Gastrointest Endosc 69:609
Pietra N, Sarli L, Costi R et al (1998) Role of follow-up in management of local recurrences of colorectal cancer: a prospective, randomized study. Dis Colon rectum 41:1127
Secco GB, Fardelli R, Gianquinto D et al (2002) Efficacy and cost of risk adapted follow-up in patients after colorectal cancer surgery: a prospective, randomized and controlled trial. Eur J Surg Oncol 28:418
Grossmann EM, Johnson FE, Virgo KS et al (2004) Follow-up of colorectal cancer patients after resection with curative intention the GILDA trial. Surg Oncol 13:119
Primrose JN, Perera R, Gray A et al (2014) Effect of 3 to 5 years of scheduled CEA and CT followup to detect recurrence of colorectal cancer: the FACS randomized clinical trial. JAMA 311:263
Wattchow DA, Weller DP, Esterman A et al (2006) General practice vs surgical-based follow-up for patients with colon cancer: randomised controlled trial. Br J Cancer 94:1116
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 metaanalysis of randomised trials. BMJ 324:813
Figueredo A, Rumble RB, Maroun J et al (2003) Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer 3:26
Jeffery M, Hickey BE, Hider PN (2007) Followup strategies for patients treated for nonmetastatic colorectal cancer. Cochrane Database Syst Rev; :CD002200
Tjandra JJ, Chan MK (2007) Follow-up after curative resection of colorectal cancer: a meta-analysis. Dis Colon rectum 50:1783
Choe EK, Park KJ, Chung SJ, Moon SH, Ryoo SB, Oh HK (2015) Colonoscopic surveillance after colorectal cancer resection: who needs more intensive follow-up? Digestion 91(2):142–149
Zeng Z, Cohen AM, Urmacher C (1993) Usefulness of carcinoembryonic antigen monitoring despite normal preoperative values in node-positive colon cancer patients. Dis Colon rectum 36(11):1063–1068
McCall JL, Black RB, Rich CA et al (1994) The value of serum carcinoembryonic antigen in predicting recurrent disease following curative resection of colorectal cancer. Dis Colon rectum 37:875
Hine KR, Dykes PW (1984) Serum CEA testing in the postoperative surveillance of colorectal carcinoma. Br J Cancer 49:689
Litvak A, Cercek A, Segal N et al (2014) False-positive elevations of carcinoembryonic antigen in patients with a history of resected colorectal cancer. J Natl Compr Cancer Netw 12:907
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Godhi, S., Godhi, A., Bhat, R. et al. Colorectal Cancer: Postoperative Follow-up and Surveillance. Indian J Surg 79, 234–237 (2017). https://doi.org/10.1007/s12262-017-1610-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-017-1610-6