Intensive Monitoring Increased Surgery for CRC Recurrence

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Intensive Monitoring Increased Surgery for CRC Recurrence
Intensive Monitoring Increased Surgery for CRC Recurrence

(HealthDay News) — For patients who have undergone curative surgery for primary colorectal cancer, intensive monitoring is associated with increased surgical treatment of recurrence compared with minimum follow-up, but it does not reduce the number of deaths, according to a study published in the Jan. 15 issue of the Journal of the American Medical Association.

John N. Primrose, MD, from the University of Southampton in the United Kingdom, and colleagues examined the effect of scheduled blood measurement of carcinoembryonic antigen (CEA) and computed tomography (CT) as follow-up for 1,202 eligible patients who underwent curative surgery for primary colorectal cancer. Participants were randomized to CEA only (n=300), CT only (n=299), CEA+CT (n=302), or minimal follow-up (follow-up only in case of symptom occurrence; n=301).

After a mean of 4.4 years of observation, the researchers detected recurrence in 199 participants (16.6%) overall. Surgical treatment of recurrence with curative intent was undertaken in 5.9% of the cohort overall, with rates of 2.3% in the minimum follow-up group, 6.7% in the CEA group, 8% in the CT group, and 6.6% in the CEA+CT group. 

There was no significant difference in the number of deaths between the combined intensive monitoring groups (CEA, CT, CEA+CT, 18.2%) and the minimum follow-up group (15.9%; difference, 2.3% [95% CI, −2.6% to 7.1%]).

"Among patients who had undergone curative surgery for primary colorectal cancer, intensive imaging or CEA screening each provided an increased rate of surgical treatment of recurrence with curative intent compared with minimal follow-up; there was no advantage in combining CEA and CT," the researchers wrote.

One author disclosed financial ties to GP Update Ltd.

References

  1. Primrose JN, Perera R, Gray A, et al. Effect of 3 to 5 Years of Scheduled CEA and CT Follow-up to Detect Recurrence of Colorectal Cancer: The FACS Randomized Clinical Trial. JAMA. 2014;311(3):263-270.

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