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01.10.2010 | Colorectal Cancer | Ausgabe 10/2010

Annals of Surgical Oncology 10/2010

Inadequate Quality of Surveillance after Curative Surgery for Colon Cancer

Annals of Surgical Oncology > Ausgabe 10/2010
MD Carsten T. Viehl, MD Alex Ochsner, MD Urs von Holzen, MD Ramona Cecini, MD Igor Langer, MD, MHS Ulrich Guller, MD Urban Laffer, MD Daniel Oertli, MD Markus Zuber
Wichtige Hinweise
Carsten T. Viehl and Alex Ochsner equally contributed to this paper
Presented in part at the 62nd Annual Cancer Symposium of the Society of Surgical Oncology, Phoenix, AZ, March 5–8, 2009



Colon cancer patients are at risk for recurrence. Recurrent disease might be curable if detected early by surveillance. However, data on the quality of surveillance are scarce. The objective of this study is to analyze the quality of surveillance after curative surgery for colon cancer among a cohort of Swiss patients.

Patients and Methods

After curative surgery, 129 stage I–III colon cancer patients were followed by chart review, questionnaires, and phone interviews. National surveillance guidelines mandate periodic measurement of carcinoembryonic antigen (CEA) levels, abdominal ultrasound or computed tomography (US/CT), and colonoscopy. However, surveillance was left to the discretion of the treating physicians. Actual surveillance was compared with the recommendations in the guidelines.


Datasets of all 129 patients were available. Median follow-up was 33.5 months (range 5.6–74.7 months). Eighteen patients (14.0%) recurred during follow-up. Three-year overall and disease-free survival were 94.7% and 83.5%, respectively. Periodic CEA measurements, US/CT, and colonoscopies as recommended by the guidelines were performed in 32.8%, 31.7%, and 23.8% of patients, respectively. Forty-four patients (34.1%) received adjuvant chemotherapy. For these patients there was a trend towards better compliance with national surveillance guidelines than for patients without adjuvant chemotherapy.


The quality of surveillance after curative surgery for colon cancer among a cohort of Swiss patients is inadequate. Further education of health care professionals and patients regarding the potential life-saving benefits of surveillance is imperative. It is cardinal that quality of surveillance is critically analyzed in other countries with different health care systems as well.

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