[Prospective follow-up study of radically resected colorectal carcinoma. Status after 5 years]

Abstract

207 patients curatively resected for colorectal cancer have been followed up in a prospective, controlled study using serial CEA, ultrasound, colonoscopy and clinical examination for early detection of recurrent tumor. After a median follow-up of 2.5 years, 52 recurrences (25%) have been detected, rising CEA value being the most sensitive indicator (86%) among the diagnostic procedures. 26 patients were reoperated for recurrent disease; in 10 out of 19 patients with local and 3 out of 7 patients with distant recurrence a potentially curative resection was possible. Median survival of patients not operated upon (n = 26) or incompletely resected (n = 13) is 8.5 months, whereas median survival for the 13 patients reoperated for cure has not yet been reached at 2 1/2 years. With respect to resectability, thorough clinical examination and endoscopy have been the most sensitive examinations (both 44%). Aggressive follow-up for suitable patients with colorectal cancer will detect most of the recurrences in an early asymptomatic phase, increase the rate of resectability and prolong survival in selected, curatively reresected cases.