Surgery today · 2020
Less intensive surveillance after radical surgery for stage I-III colorectal cancer by focusing on the doubling time of recurrence.
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Miyake Hiroaki, Kawai Kazushige, Nozawa Hiroaki, Sasaki Kazuhito, Kaneko Manabu, Murono Koji, Emoto Shigenobu, Ishii Hiroaki, Sonoda Hirofumi, Ishihara Soichiro
Аннотация
PURPOSE: To propose a new and improved surveillance schedule for colorectal cancer (CRC) patients by focusing on the recurrence rate, resectability, and especially, the tumor doubling time (DT) of recurrent tumors.
METHODS: The subjects of this retrospective review were 1774 consecutive patients who underwent radical surgery for stage I-III CRC between January, 2004 and December, 2015. We calculated the DT by measuring the tumor diameter using computed tomography (CT).
RESULTS: The median DT for recurrences in the liver, lung, peritoneum, and other locations were 35, 72, 85, and 36 days, respectively, (p < 0.001) and tumor growth rates differed according to the organs where recurrence developed. Multiple linear regression analysis showed that the DT was strongly associated with the relapse-free interval from primary surgery (p < 0.001), and that the DT in patients with recurrence detected ≥ 3 years after primary surgery was longer by 151.1 days than that in patients with recurrence detected within 1 year after primary surgery. We proposed a less intensive surveillance, which achieved an average cost reduction of 32.5% compared with conventional surveillance in Japan.
CONCLUSION: We propose a new and more cost-efficient surveillance schedule for CRC surgery patients in the clinical setting.
METHODS: The subjects of this retrospective review were 1774 consecutive patients who underwent radical surgery for stage I-III CRC between January, 2004 and December, 2015. We calculated the DT by measuring the tumor diameter using computed tomography (CT).
RESULTS: The median DT for recurrences in the liver, lung, peritoneum, and other locations were 35, 72, 85, and 36 days, respectively, (p < 0.001) and tumor growth rates differed according to the organs where recurrence developed. Multiple linear regression analysis showed that the DT was strongly associated with the relapse-free interval from primary surgery (p < 0.001), and that the DT in patients with recurrence detected ≥ 3 years after primary surgery was longer by 151.1 days than that in patients with recurrence detected within 1 year after primary surgery. We proposed a less intensive surveillance, which achieved an average cost reduction of 32.5% compared with conventional surveillance in Japan.
CONCLUSION: We propose a new and more cost-efficient surveillance schedule for CRC surgery patients in the clinical setting.