[A tumor after-care schedule: information content--use--optimization]

Abstract

Follow-up schedules for cancer patients define standards for post treatment care. They give informations about (1) the group of patients at risk, (2) the location of metastasis, (3) the adequate diagnostic procedures, (4) the frequency of examinations, and (5) the overall duration of follow-up. Such recommendations are a concise compilation of knowledge about the course of the disease, the tumor growth kinetics, and characteristics of the diagnostic tests. The validity of routine follow-up schedules will be discussed and explained using data about liver metastases in breast cancer patients. Simple calculations and simulations about the frequency of metastatic events demonstrate that strategies oriented on prognosis should be mandatory. The frequency of the detection of secondary cancers, the therapeutic possibilities etc. should define limits for the search of metastases. The effectiveness of follow-up programs must be evaluated just as the screening for the detection of early cancers in order to optimize the cost-benefit-relations.