Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials.

2.50
Hdl Handle:
http://hdl.handle.net/10541/54753
Title:
Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials.
Authors:
Renehan, Andrew G; Egger, Matthias; Saunders, Mark P; O'Dwyer, Sarah T
Abstract:
OBJECTIVE: To review the evidence from clinical trials of follow up of patients after curative resection for colorectal cancer. DESIGN: Systematic review and meta-analysis of randomised controlled trials of intensive compared with control follow up. MAIN OUTCOME MEASURES: All cause mortality at five years (primary outcome). Rates of recurrence of intraluminal, local, and metastatic disease and metachronous (second colorectal primary) cancers (secondary outcomes). RESULTS: Five trials, which included 1342 patients, met the inclusion criteria. Intensive follow up was associated with a reduction in all cause mortality (combined risk ratio 0.81, 95% confidence interval 0.70 to 0.94, P=0.007). The effect was most pronounced in the four extramural detection trials that used computed tomography and frequent measurements of serum carcinoembryonic antigen (risk ratio 0.73, 0.60 to 0.89, P=0.002). Intensive follow up was associated with significantly earlier detection of all recurrences (difference in means 8.5 months, 7.6 to 9.4 months, P<0.001) and an increased detection rate for isolated local recurrences (risk ratio 1.61, 1.12 to 2.32, P=0.011). CONCLUSIONS: Intensive follow up after curative resection for colorectal cancer improves survival. Large trials are required to identify which components of intensive follow up are most beneficial.
Affiliation:
Department of Surgery, Christie Hospital NHS Trust, Manchester M20 4BX. arenehan@picr.man.ac.uk
Citation:
Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. 2002, 324 (7341):813 BMJ
Journal:
BMJ (Clinical Research Edition)
Issue Date:
6-Apr-2002
URI:
http://hdl.handle.net/10541/54753
DOI:
10.1136/bmj.324.7341.813
PubMed ID:
11934773
Type:
Article
Language:
en
ISSN:
1468-5833
Appears in Collections:
All Christie Publications ; Clinical Oncology

Full metadata record

DC FieldValue Language
dc.contributor.authorRenehan, Andrew G-
dc.contributor.authorEgger, Matthias-
dc.contributor.authorSaunders, Mark P-
dc.contributor.authorO'Dwyer, Sarah T-
dc.date.accessioned2009-03-12T12:53:19Z-
dc.date.available2009-03-12T12:53:19Z-
dc.date.issued2002-04-06-
dc.identifier.citationImpact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. 2002, 324 (7341):813 BMJen
dc.identifier.issn1468-5833-
dc.identifier.pmid11934773-
dc.identifier.doi10.1136/bmj.324.7341.813-
dc.identifier.urihttp://hdl.handle.net/10541/54753-
dc.description.abstractOBJECTIVE: To review the evidence from clinical trials of follow up of patients after curative resection for colorectal cancer. DESIGN: Systematic review and meta-analysis of randomised controlled trials of intensive compared with control follow up. MAIN OUTCOME MEASURES: All cause mortality at five years (primary outcome). Rates of recurrence of intraluminal, local, and metastatic disease and metachronous (second colorectal primary) cancers (secondary outcomes). RESULTS: Five trials, which included 1342 patients, met the inclusion criteria. Intensive follow up was associated with a reduction in all cause mortality (combined risk ratio 0.81, 95% confidence interval 0.70 to 0.94, P=0.007). The effect was most pronounced in the four extramural detection trials that used computed tomography and frequent measurements of serum carcinoembryonic antigen (risk ratio 0.73, 0.60 to 0.89, P=0.002). Intensive follow up was associated with significantly earlier detection of all recurrences (difference in means 8.5 months, 7.6 to 9.4 months, P<0.001) and an increased detection rate for isolated local recurrences (risk ratio 1.61, 1.12 to 2.32, P=0.011). CONCLUSIONS: Intensive follow up after curative resection for colorectal cancer improves survival. Large trials are required to identify which components of intensive follow up are most beneficial.en
dc.language.isoenen
dc.subjectColorectal Canceren
dc.subjectCancer Metastasis-
dc.subject.meshColorectal Neoplasms-
dc.subject.meshHumans-
dc.subject.meshLong-Term Care-
dc.subject.meshNeoplasm Metastasis-
dc.subject.meshPostoperative Period-
dc.subject.meshRandomized Controlled Trials as Topic-
dc.subject.meshRecurrence-
dc.subject.meshSurvival Rate-
dc.titleImpact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, Christie Hospital NHS Trust, Manchester M20 4BX. arenehan@picr.man.ac.uken
dc.identifier.journalBMJ (Clinical Research Edition)en

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