Significance of Intensive Follow up by using CT after Curative Resection for Colorectal Cancer

Roppei Yamada, Makoto Akaike, Manabu Shiozawa, Hiroyuki Saeki, Yukio Sugimasa, Shoji Takemiya, Hisahiko Motohashi and Toshio Imada*

Department of Gastrointestinal Surgery, Kanagawa Cancer Center
Yokohama City University Medical Center*

Introduction: We evaluated the significance of surveillance for recurrence after operation with curative surgery intent in colorectal cancer patients. Patients and methods: Subjects were 126 patients with colorectal cancer who underwent curative resection from 1986 to 2001 at the Kanagawa Cancer Center recurred and suffered in a single organ. We divided them into 2 groups: group I (n=60) whose recurrence was detected by intensive follow-up by using CT every 4 months, and group C (n=66) whose recurrence detected by conventional follow-up CT once a year, we compared median survival time (MST), disease-free survival interval (DFI) and survival time after recurrence (SAR) retrospectively. Results: DFI was 690 ± 63 days in group C, compared to 467 ± 40 days in group I. SAR was 767 ± 211 days in group C, compared to 943 ± 89 days in group I. In lung recurrence (n=36), SAR was 925 ± 333 days in group C, compared to 1,296 ± 461 days in group I. Elevation of tumor markers at recurrence was observed in 41 of 47 cases (89%) in liver recurrence. Symptoms at recurrence were observed in 12 of 14 cases (83%) in local recurrence. Conclusion: Intensive follow-up by using CT does not improve SAR, but in lung recurrence which is difficult to detect by tumor markers or examination could improves SAR.

Key words
colorectal cancer, intensive follow-up, conventional follow-up, survival time after recurrence, recurrent pattern

Reprint requests
Roppei Yamada Yokohama City University Medical Center
4-57 Urafunecho, Minami-ku, Yokohama, 232-0024 JAPAN

Accepted
October 19, 2004

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