Patient-led follow-up after curative colorectal cancer surgery: The primary outcome analysis of the prospective, multicentre FUTURE-primary implementation study.

BACKGROUND

A structured follow-up regimen is standard for most cancer survivors. As this population grows, there is increasing interest in more sustainable and patient-centred follow-up strategies. Previous studies suggest that home-based follow-up after curative treatment is non-inferior to hospital-based care regarding survival and quality of life. The FUTURE-primary study aims to evaluate the feasibility of a patient-led, home-based follow-up model for colorectal cancer survivors.

METHODS

The FUTURE-primary study is a prospective, multicentre implementation study. Patients who had undergone curative-intent surgery for primary colorectal cancer and were eligible for standard follow-up could personalise their care pathway. Options included the frequency of follow-up, location of blood sampling (home, local facility, or hospital), and communication method ('silent', telephone, or in-person). The minimal follow-up schedule consisted of seven mandatory consultations over five years, in accordance with national guidelines. In addition, seven optional follow-up moments were available, allowing patients additional follow-up where needed.

FINDINGS: Data from 209 patients were analysed. Of 1463 optional follow-up moments, 488 (33 %) remained unused, surpassing the pre-defined threshold of 25 % and thereby meeting the primary endpoint. Home-based blood sampling was preferred by 66 % of patients, while 70 % chose telephone consultations over physical appointments.

INTERPRETATION: Patient-led follow-up after curative colorectal cancer surgery is feasible and acceptable. The model may reduce unnecessary hospital visits, improve patient autonomy, and contribute to more sustainable cancer survivorship care. Its principles are potentially applicable to other tumour types and care pathways.

FUNDING: This study was funded by the Dutch Cancer Society (KWF Kankerbestrijding), grant number 9030.