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Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials.
Renehan, Andrew G Egger, Matthias Saunders, Mark P O'Dwyer, Sarah T
Renehan, Andrew G
Egger, Matthias
Saunders, Mark P
O'Dwyer, Sarah T
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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.
Description
Date
2002-04-06
Publisher
Collections
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813.full.pdf
Adobe PDF, 275.86 KB
Keywords
Colorectal Cancer
Cancer Metastasis
Cancer Metastasis
Type
Article
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