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12.09.2019 | Original Article

Is follow-up still mandatory more than 5 years after surgery for colorectal cancer?

Zeitschrift:
Updates in Surgery
Autoren:
Alice Frontali, Benjamin Benichou, Ionut Valcea, Léon Maggiori, Justine Prost à la Denise, Yves Panis
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Abstract

Purpose

The aim of this study was to assess if to prolong follow-up (FU) more than 5 years after surgery for colorectal cancer (CRC) is justified or not.

Methods

Patients who underwent surgery for a CRC before 2013 and without any tumor recurrence (or synchronous metastases) during the first 5 years after surgery were identified from our database and included.

Results

Between 1996 and 2012, 121 patients operated for rectal (RC) (median of FU of 84 months; range 60–211) and 97 with colonic cancer (CC) (median of FU of 78 months; range 60–139), without any tumor recurrence (or synchronous metastases) during the first 5 years after surgery, presented a late tumor recurrence: 13/121 RC (10.7%) versus 2/97 CC (2.1%) (p = 0.014); 8/13 recurrences in RC (61.5%) were observed after neoadjuvant radiochemotherapy, and 9/13 (69.2%) in pN0 tumors. Among the 13 recurrences, 3 had both local and metastatic recurrences (23%), 5 an isolated local recurrence (38.5%) and 5 an isolated metastatic recurrence (38.5%). After surgery for CC, the 2 recurrences were observed in patients with T3N0 tumors.

Conclusion

After surgery for a CRC, in patients without tumor recurrence during the first 5 years after surgery, follow-up after 5 years must be continued in rectal cancer patients because of a 10.7% rate of late recurrence. On the opposite, after surgery for colon cancer the 2% rate of late recurrence after 5 years suggested that only patients with pT3–T4 colonic cancer could probably be followed more than 5 years after surgery.

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