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:5/26/2017)... ... 2017 , ... After raising nearly $30,000 on Kickstarter , about three-times ... at a discounted crowdfunding price on Indiegogo . , “Along with creating an ... to bring a fidget toy to the market that was made of superior quality ...
(Date:5/26/2017)... ... May 26, 2017 , ... “When the Stars Lead Home”: a poignant ... of published author Laura Weigel Douglas, an avid reader who lives in the Pacific ... sometimes feels like Green Hills Adventure Camp. She couldn’t be more grateful. , Twelve-year ...
(Date:5/26/2017)... (PRWEB) , ... May 26, 2017 , ... Water damage ... Lee, New Jersey School District had left education officials with a number of critical ... replacement of the flooring had to be accomplished with little or no disruption to ...
(Date:5/24/2017)... ... 24, 2017 , ... NucleusHealth ™, advancing clinical practice ... Food and Drug Administration (FDA) 510(k) clearance for its Nucleus.io ... for medical image management. At the core is patented streaming technology that provides ...
(Date:5/24/2017)... ... May 24, 2017 , ... Myers Jackson is well ... the ability to sell luxury homes anywhere on the planet. The luxury home market ... from Hattiesburg to Houston city-scapes. A quick search of “11 Spyglass Hill Auction will ...
Breaking Medicine News(10 mins):
(Date:5/9/2017)... 9, 2017 Zimmer Biomet Holdings, Inc. (NYSE ... today announced it has earned a spot on ... The Company was ranked among 500 U.S. employers as ... Healthcare Equipment and Services. The annual ... anonymous, independent survey of over 30,000 employees across 25 ...
(Date:5/9/2017)... 2017  Semler Scientific, Inc. (OTCQB: SMLR), an ... improve the clinical effectiveness and efficiency of healthcare ... quarter ended March 31, 2017. ... to identify when preventive care options are appropriate, ... heart attacks or strokes occur," said Doug ...
(Date:5/6/2017)... , May 5, 2017   Provista , a proven ... than 200,000 customers, today announced Jim Cunniff as ... of executive and business experience to Provista, including most recently ... in California . He assumed his new ... is a great fit for Provista," says Jody Hatcher ...
Breaking Medicine Technology: