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Titolo:
AN EVALUATION OF POSTOPERATIVE FOLLOW-UP TESTS IN COLON-CANCER PATIENTS TREATED FOR CURE
Autore:
PEETHAMBARAM P; WEISS M; LOPRINZI CL; NOVOTNY P; OFALLON JR; ERLICHMAN C; OCONNELL MJ; LAURIE JA;
Indirizzi:
MAYO CLIN & MAYO FDN,200 1ST ST SW ROCHESTER MN 55905 MAYO CLIN & MAYO FDN ROCHESTER MN 55905 GRAND FORKS CLIN LTD GRAND FORKS ND 00000
Titolo Testata:
Oncology
fascicolo: 4, volume: 54, anno: 1997,
pagine: 287 - 292
SICI:
0030-2414(1997)54:4<287:AEOPFT>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLORECTAL-CARCINOMA; CARCINOEMBRYONIC ANTIGEN; SURGICAL-TREATMENT; ADJUVANT THERAPY; 2ND-LOOK SURGERY; RESECTION; METASTASES; FLUOROURACIL; RECURRENCE; RECTUM;
Keywords:
COLON CANCER; FOLLOW-UP; TESTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
22
Recensione:
Indirizzi per estratti:
Citazione:
P. Peethambaram et al., "AN EVALUATION OF POSTOPERATIVE FOLLOW-UP TESTS IN COLON-CANCER PATIENTS TREATED FOR CURE", Oncology, 54(4), 1997, pp. 287-292

Abstract

Background: Currently patients with colon cancer who are potentially cured by surgery are followed periodically with physical examinations,blood tests and imaging studies to detect tumor recurrence early, on the presumption that intervention can affect outcome. There is little information to indicate whether frequent visits to the doctor's officeor frequent testing improves survival or quality of life. Methods: Ninety-eight patients with resected stage B2, B3 or C (modified Astler-Coller) colon cancer who developed recurrent disease while enrolled in prospective adjuvant trials at Mayo Clinic sponsored by the North Central Cancer Treatment Group were studied to evaluate the utility of follow-up tests to detect the first recurrence of colon cancer and the outcome following various interventions for these recurrences. These patients had a history, physical examination, complete blood count, chemistry panel and chest x-ray approximately every 3-4 months in the 1st year and then every 6-12 months thereafter for a total of 5 years. Bowel evaluation was done at 6 months, 12 months and annually thereafter. In addition, a minority of patients had carcinoembryonic antigen (CEA)testing, and radioisotope liver scans at various intervals. Results: Symptoms signaled the diagnosis of recurrent disease in 55 patients, physical examination in 4 patients, and abnormalities in chest x-ray in18 patients. An elevated CEA was the initial abnormal test in 5 patients, abnormal liver scans in 5 patients, elevated liver function testsin 6 patients and laparotomy for other reasons in 2 patients. Hemoglobin, barium enema, and fecal blood testing were useful in 1 patient each. Thirty-one percent of recurrences were diagnosed between scheduledvisits. In our series, histories, physical examinations, and chest x-rays led to the detection of 79% of the recurrences while liver function tests, liver scans and CEAs led to the detection of 16% of recurrences. Sixteen patients underwent resection for cure for their first recurrence; the diagnosis of recurrence was signaled by symptoms in 6 patients, chest x-ray in 6 patients and abnormal liver function tests, CEA, hemoglobin, and laparotomy for colostomy closure in 1 patient each.conclusions: The majority of tumor recurrences were detected by symptoms, physical examinations and chest x-rays. Testing for asymptomatic tumor recurrences during the ist follow-up year is likely to be much less fruitful for detecting resectable recurrences than testing patients in the 2nd through 4th follow-up years. Patients who had a disease recurrence in the 1st postoperative year were less likely to be candidates for curative intent surgery. Lower tumor grade al initial diagnosis correlated both with likelihood of undergoing secondary surgical resection and the chance of doing well following this. These data may be helpful for defining more appropriate follow-up tests for detection oftumor recurrence in patients with resected colon cancer.

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Documento generato il 26/11/20 alle ore 08:59:52