The Value of a Follow-up Programme after Radical Surgery for Colorectal Carcinoma

Abstract

To evaluate the effectiveness of a follow-up programme after curative surgery for colorectal carcinoma, a 10-year series of 402 patients was surveyed for the detection rate of potentially curative recurrences and metachronous neoplasms. There were 120 recurrences (30%), and 100 of them (83%) were detected at scheduled check ups. Initial suspicion of recurrence was most often based on physical examination, carcinoembryonic antigen assay, or sigmoidoscopy. Reoperation was undertaken in 62 patients, in 26 cases (22%) for cure. The 5-year survival was 48% after curative reoperations. Metachronous adenomas and carcinomas occurred in 38 and 11 patients, respectively, giving corresponding cumulative 5-year incidences of 13% and 3.8%. Altogether, 37 patients (9.2%) had a curative reoperation for recurrent or metachronous carcinoma, and a further 38 patients (9.5%) had adenomas removed by polypectomy. It is concluded that regular follow-up is useful for the patients, and the follow-up schedule must be planned to detect both early recurrences and metachronous neoplasms.