A prospective randomized study of follow-up after radical surgery for colorectal cancer

Abstract

Background: The possible benefit for patients from follow-up examinations after curative surgery for colorectal cancer is unproven. The purpose of this study was to determine whether survival is improved by frequent follow-up examinations.

Methods: A total of 597 patients less than 76 years old treated with radical surgery for colorectal cancer were included in the study from 1983 to 1994. Patients were randomized to frequent follow-up (group 1) or virtually no follow-up (group 2) with examinations at 5 and 10 years.

Results: Group 1 comprised 290 patients, group 2 contained 307. Recurrence was equally frequent (26 per cent), but the time of diagnosis was 9 months earlier in group 1; also, more recurrences were asymptomatic in group 1 and more patients had new surgery with curative intent (P = 0.02). However, no improvement in overall survival or in cancer-related survival resulted.

Conclusion: Patients subjected to intensive follow-up have recurrence diagnosed earlier, and have more operations for recurrence, but the survival results suggest that any major improvement by intensive follow-up is unlikely.