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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.

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    Authors
    Renehan, Andrew G
    Egger, Matthias
    Saunders, Mark P
    O'Dwyer, Sarah T
    Affiliation
    Department of Surgery, Christie Hospital NHS Trust, Manchester M20 4BX. arenehan@picr.man.ac.uk
    Issue Date
    2002-04-06
    
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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.
    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)
    URI
    http://hdl.handle.net/10541/54753
    DOI
    10.1136/bmj.324.7341.813
    PubMed ID
    11934773
    Type
    Article
    Language
    en
    ISSN
    1468-5833
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmj.324.7341.813
    Scopus Count
    Collections
    All Christie Publications
    Clinical Oncology

    entitlement

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