Hepato-gastroenterology · 2005
Postsurgical surveillance for recurrence of UICC stage I colorectal carcinoma: is follow-up by CEA justified?
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Yamamoto Seiichiro, Akasu Takayuki, Fujita Shin, Moriya Yoshihiro
Аннотация
BACKGROUND/AIMS: This study was undertaken to investigate whether it will be possible to reduce the times and types of postoperative examinations for surveillance in patients with UICC stage I colorectal carcinoma. In addition, the value of CEA in postoperative surveillance is discussed.
METHODOLOGY: A review was performed of 541 patients who underwent curative resection for UICC stage I colorectal carcinoma between January, 1985 and December, 1998. Periodic check-up was routinely conducted to identify recurrence.
RESULTS: The median follow-up was 82 months. The recurrence rate was 2.9% in the UICC stage Ia (pT1N0M0) group, and 5.6% in the Ib (pT2N0M0) group. Cancer-specific survival rates at 5 years were 99.3% and 97.6%, respectively (p=0.0354). Recurrences occurred more frequently in patients with lower rectal carcinoma (p=0.0415). Curative-intent salvage surgery was performed in 61.9% (13/21) for recurrent lesions. Between the patients who were CEA positive (13/21; 61.9%) and those who were CEA negative at the time of recurrence, there was no significant difference in the prognosis.
CONCLUSIONS: The incidence of recurrence was low after curative surgery in patients with UICC stage I colorectal carcinoma, and it is therefore possible to reduce times and types of postoperative examinations. CEA measurement alone appears to be sufficient.
METHODOLOGY: A review was performed of 541 patients who underwent curative resection for UICC stage I colorectal carcinoma between January, 1985 and December, 1998. Periodic check-up was routinely conducted to identify recurrence.
RESULTS: The median follow-up was 82 months. The recurrence rate was 2.9% in the UICC stage Ia (pT1N0M0) group, and 5.6% in the Ib (pT2N0M0) group. Cancer-specific survival rates at 5 years were 99.3% and 97.6%, respectively (p=0.0354). Recurrences occurred more frequently in patients with lower rectal carcinoma (p=0.0415). Curative-intent salvage surgery was performed in 61.9% (13/21) for recurrent lesions. Between the patients who were CEA positive (13/21; 61.9%) and those who were CEA negative at the time of recurrence, there was no significant difference in the prognosis.
CONCLUSIONS: The incidence of recurrence was low after curative surgery in patients with UICC stage I colorectal carcinoma, and it is therefore possible to reduce times and types of postoperative examinations. CEA measurement alone appears to be sufficient.