[Time to institute more active follow up after curative surgery for colorectal cancer? Wide variation of follow up and diagnostic routines]

Abstract

There are still no large controlled studies that have proved any survival benefit with intensive follow-up after curative surgery for colorectal cancer. There is a wide variation in follow-up. Three meta-analysis have shown that intensive follow-up can improve survival, the most recent based on five previously published small controlled trials that compared intensive with control follow-up. Since the randomised studies were initiated, there have been a strong development of rectal cancer surgery and surgery for livermetastasis as well as for adjuvant and palliative oncologic treatments. This development gives support to a more active attitude towards intensive regular follow-up. An active follow-up should be selective and only include patients who tolerate oncologic or surgical treatment. Diagnostic tests to find intraluminal recurrence are ineffective. Large multicenter studies are still warranted.