Navigation Links
Follow-up tests improve colorectal cancer recurrence detection
Date:1/14/2014

Among patients who had undergone curative surgery for primary colorectal cancer, the screening methods of computed tomography and carcinoembryonic antigen each provided an improved rate of surgical treatment of cancer recurrence compared with minimal follow-up, although there was no advantage in combining these tests, according to a study in the January 15 issue of JAMA.

Colorectal cancer is the third most common cancer worldwide, with 1.24 million cases reported to the International Agency for Research on Cancer in 2008. Traditionally, patients who have had curative surgery for colorectal cancer undergo regular follow-up for at least 5 years to detect recurrence, a common practice based on limited evidence, according to background information in the article.

John N. Primrose, M.D., F.R.C.S., of the University of Southampton, England, and colleagues assessed detection of recurrence using two common screening methods: measurement of blood carcinoembryonic antigen (CEA; a glycoprotein used as a tumor marker), and computed tomography (CT). They randomized 1,202 patients from 39 hospitals in England to 1 of 4 groups: CEA only (n = 300), CT only (n = 299), CEA+CT (n = 302), or minimum follow-up (n = 301).

Cancer recurrence was detected in 199 participants (16.6 percent) during the period of observation for recurrence (average 4.4 years), and 5.9 percent of participants with recurrence underwent surgery for cure (recurrence detected early enough via follow-up test that surgery can still be performed for cure). The researchers found that surgical treatment of recurrence with curative intent was higher in each of the 3 more intensive follow-up groups compared with the minimum follow-up group. Compared with minimum follow-up, the absolute difference in the number treated with curative intent in the CEA group was 4.4 percent, 5.7 percent in the CT group, and 4.3 percent in the CEA+CT group.

The number of deaths was nonsignificantly higher in the more intensive follow-up groups compared with the minimum follow-up group, as was the number of disease-specific colorectal cancer deaths. "More than two-thirds of the patients treated surgically with curative intent were still alive at a median [midpoint] follow-up of just over 4 years postrecurrence, suggesting that 5-year survival may be more than the 40 percent previously reported," the authors write. They note that if there is a survival advantage to any strategy, it is likely to be small, but either test is better than no follow-up testing.

"The benefits of follow-up appear to be independent of diagnostic stage (because although there are fewer recurrences with better-stage tumors, they are more likely to be curable), suggesting that stage-specific follow-up strategies may not be necessary. However, thorough staging investigation at the end of primary treatment to detect residual disease is still important because a large number of 'recurrences' reported in routine series are probably residual disease that should be detected and treated before embarking on follow-up."


'/>"/>

Contact: John N. Primrose
j.n.primrose@soton.ac.uk
The JAMA Network Journals
Source:Eurekalert

Related medicine news :

1. The doctor will text you now: Post-ER follow-up that works
2. Five-Year Follow-Up Data on CERAMENT™
3. BONE VOID FILLER Demonstrates Long-Term Safety and Long-Lasting Bone Mineral Density Improvement in Osteoporotic Patients
4. Children with elevated blood pressure dont get recommended follow-up, few at risk for hypertension
5. Ten-Year Follow-Up by AGH Doctors Confirms Effectiveness of Less-Invasive Surgery for Women With Early Stage Breast Cancer
6. New York City successfully locates HIV-positive patients lost to follow-up
7. Nephrologist follow-up improves mortality of severe acute kidney injury patients
8. Chernobyl follow-up study finds high survival rate among young thyroid cancer patients
9. Follow-Up Care After Chest Pain Called Crucial
10. Evidence shows concussions require long-term follow-up for players
11. 5-year follow-up - over half of all ACL reconstructions could be avoided
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:9/19/2017)... ... September 19, 2017 , ... Trusted debt-reduction firm CreditAssociates, LLC has announced two ... in excess of $835 million in resolved debt for its clients. , Credit card ... of the categories of debt settled by the company. With more than a decade ...
(Date:9/19/2017)... ... September 19, 2017 , ... Arizona-based ... as the President of its HealthBI division. McFarland will grow the organization’s ... , “Scott is a utility player who balances his day as a ...
(Date:9/19/2017)... Hill, CT (PRWEB) , ... September 19, 2017 ... ... support, today announced the winners of the Entrepreneur Innovation Awards (EIA), held this ... all of whom are Connecticut-based companies and entrepreneurs, presented their innovative project ideas ...
(Date:9/19/2017)... ... September 19, 2017 , ... MelaKids, a Laredo-based company, has introduced a new ... we’re born, Nature gives us a full supply of melanin – in the back ... this natural glare-reducing pigment; however, around the age of thirty, we develop a yellow-brown ...
(Date:9/19/2017)... ... September 19, 2017 , ... Presenting its annual ... (SPBA) hosted “Expanding Your Success” with an educational emphasis. , The three-day ... best practices for third party administrators (TPAs) related to health plan management and ...
Breaking Medicine News(10 mins):
(Date:9/5/2017)... , Sept. 5, 2017 Oramed Pharmaceuticals Inc. ... ), a clinical-stage pharmaceutical company focused on the development ... has successfully concluded its meeting with the U.S. Food ... oral insulin formulation. ... the regulatory pathway for submission of ORMD-0801, would be ...
(Date:9/1/2017)...  Bayer will present the latest research from across its ... (ESMO) 2017 Congress, September 8-12 in Madrid, Spain ... clinical data on Bayer,s marketed portfolio and late-stage compounds as ... "We value the opportunity to ... at ESMO," said Carsten Brunn , Head of Pharmaceuticals, ...
(Date:8/29/2017)... 29, 2017 In a move that promises ... compliance for veterinary practices of all sizes, Cubex LLC ... that makes TITAN,s expertise in physical security, drug diversion ... clients nationally. ... controlled substances is at risk today," said TITAN founder ...
Breaking Medicine Technology: