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:1/19/2017)... ... ... Today, the Centers for Medicare & Medicaid Services (CMS) announced over 359,000 ... in 2017. Clinicians who participate in APMs are paid for the quality of care ... effort to build a system that delivers better care and one in which clinicians ...
(Date:1/19/2017)... ... ... Next week after January 20th, the fear for many is that the ... needs of over 30 million. Many interviews with Dr. Carol Francis at the Los ... were suppose to prioritize. Interviews provided below. , Among those present was ...
(Date:1/19/2017)... ... January 19, 2017 , ... With the cold weather here, many people will have to clear ... when clearing large amounts of snow, but they can be dangerous when used incorrectly. That’s ... Safety Commission for the proper use of snow blowers:, , When ...
(Date:1/19/2017)... ... January 19, 2017 , ... ... engineers, and scientists from around the world, announces the launch of its newly ... and easy portal to research breakthroughs and trending news, vital information on upcoming ...
(Date:1/19/2017)... Melville, New York (PRWEB) , ... January 19, ... ... state–of-the-art high definition dynamic telemedicine solutions, has recently unveiled impressive transportable capabilities with ... this newly designed product is an extension to RMT technology that delivers HD, ...
Breaking Medicine News(10 mins):
(Date:1/19/2017)... , Jan. 19, 2017  Abaxis, Inc. (NasdaqGS: ... point-of-care blood analysis instruments and consumables for the medical ... to discuss its financial results for the third quarter ... will be at 4:15 p.m. ET on Thursday, January ... the third quarter fiscal year 2017 after the market ...
(Date:1/19/2017)... RATON, Fla. , Jan. 19, 2017 /PRNewswire/ ... a medical device company specializing in the treatment ... such as keloids, with superficial radiation therapy, today ... and full year 2016 financial results on Thursday, February ... The Company will hold a conference call with ...
(Date:1/19/2017)... , January 19, 2017 ... announced that the U.S. Food and Drug Administration (FDA) ... a New Drug Application (NDA) for SHP465, a long-acting, ... as a potential once-daily treatment for Attention-Deficit/Hyperactivity Disorder (ADHD). ... or around June 20, 2017, the designated Prescription Drug ...
Breaking Medicine Technology: