scholarly journals Intensive Follow-Up After Curative Surgery for Colorectal Cancer

2017 ◽  
Vol 30 (9) ◽  
pp. 633 ◽  
Author(s):  
Rita Vale Rodrigues ◽  
João Pereira da Silva ◽  
Isadora Rosa ◽  
Isabel Santos ◽  
Nuno Pereira ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Curative Treatment ◽  
Rank Test ◽  
Surveillance Program ◽  
Curative Surgery ◽  
Cancer Antigen ◽  
Chi Square ◽  
Postoperative Surveillance

Introduction: The purpose of postoperative surveillance programs after curative treatment for colorectal cancer is to detect asymptomatic recurrences with the premise that an important rate will be eligible for curative resection, improving overall survival. We have implemented a surveillance program for patients with colorectal cancer, stages II-III, with periodic clinical, carcinoembryonic antigen and cancer antigen-19-9 assessment, computed tomography and colonoscopy. The aim of this study was to assess the rate of curative treatment of recurrence, colorectal cancer mortality and clinical characteristics associated with non-resectable recurrence.Material and Methods: Open cohort study, single center. All patients on the intensive surveillance program between March 2008 and January 2015 were included. Statistics: chi-square, Wilcoxon rank sum test, logistic regression, Kaplan-Meier log-rank test (SPSS20®).Results: We had a total 404 patients evaluated; 59.6% male; mean age of 65 ± 10 years; 50.7% rectal tumor; 56.2% stage III. The average time of follow-up was 37 months and the recurrence rate was 12.9% (n = 52), mostly detected in the first three years (88.4%). The pattern of recurrence was associated with the site of the primary tumor (p < 0.001). Twenty-one patients underwent curative resection. Factors associated with non-resectable recurrence were aged ≥ 70 years (p = 0.022), disease location in the colon (p = 0.033) and cancer antigen-19-9-9 elevation (p = 0.024). The overall rate of cancer-specific mortality was 2.2% (n = 9).Discussion: The association between colon cancer and non-resectable recurrence is explained by the higher rate of disseminated disease in these patients. Cancer antigen-19-9 added no benefit to the surveillance program.Conclusion: This intensive real-world postoperative surveillance program allowed performing curative surgery to 40.3% of patients with recurrence.

Follow-Up After Curative Resection of Colorectal Cancer: A Meta-Analysis

2007 ◽  
Vol 50 (11) ◽  
pp. 1783-1799 ◽  
Author(s):  
Joe J. Tjandra ◽  
Miranda K. Y. Chan
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Meta Analysis

Serum p53 Antibody as Tumor Marker for Follow-Up of Colorectal Cancer After Curative Resection

2009 ◽  
Vol 16 (9) ◽  
pp. 2516-2523 ◽  
Author(s):  
Reiping Tang ◽  
Chien Yuh Yeh ◽  
Jeng-Yi Wang ◽  
Chung Rong Changchien ◽  
Jinn-Shiun Chen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Marker ◽  
Curative Resection ◽  
Serum P53 Antibody ◽  
Serum P53 ◽  
P53 Antibody

scholarly journals Evaluation of a follow-up programme after curative resection for colorectal cancer

1998 ◽  
Vol 79 (2) ◽  
pp. 308-310 ◽  
Author(s):  
J D Howell ◽  
H Wotherspoon ◽  
E Leen ◽  
T C Cooke ◽  
C S McArdle
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection

Metachronous cancer after endoscopic submucosal dissection of gastric neoplasia.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 559-559
Author(s):  
Jae Myung PARK ◽  
Seung Bae Yoon ◽  
Kyo Young Song ◽  
Chun-Hyun Lim ◽  
Yu Kyung Cho ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Carcinoma ◽  
Cancer Recurrence ◽  
Clinicopathological Characteristics ◽  
Rank Test ◽  
Surveillance Program ◽  
Gastric Adenoma ◽  
Significant Difference ◽  
Gastric Neoplasia

559 Background: Metachronous recurrence after endoscopic resection (ER) of gastric cancer is known to be high. However, recurrence rate of metachrous lesions after ER of gastric adenoma has not been studied well. The aim of the study was to compare the metachronous recurrence between gastric carcinoma and adenoma patients. Methods: Four hundred eight carcinoma and 539 adenoma patients were enrolled in this study, and median follow-up period was 27 months (IQR: 16-45 months). Clinicopathological characteristics were assessed. At the follow-up endoscopy, the whole gastric mucosa was examined thoroughly to detect any gastric neoplasia. All suspicious lesions were evaluated histologically on endoscopic biopsies. Surveillance endoscopic schedule was as follows: every 3–6 months within 1 year, then once every year. Results: Forty three metachronous recurrence was diagnosed in in carcinoma patients and 45 in adenoma patients. There was no significant difference in the incidence of recurrent metachronous neoplasm between carcinoma and adenoma patients (p=0.728, log-rank test). After excluding metachronous adenoma, cancer recurrence was not different either between two groups (p=0.943). After adjusting for age, sex, multiplicity, and Helicobacter pylori status, the risk of the metachronous development of gastric cancer in adenoma patients was similar with that in carcinoma patients (HR, 0.96; 95% CI, 0.63-1.45). Conclusions: Metachronous gastric cancer after ER of gastric adenoma was as high as that of gastric carcinoma. Similar endoscopic surveillance program should be applied for both gastric carcinoma and adenoma patients after ER.

Prognostic value of modified Glasgow Prognostic Score (mGPS) and neutrophil-lymphocyte ration (NLR) after curative resection for gastric cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 295-295
Author(s):  
Yusuke Shimodaira ◽  
Sachie Koike ◽  
Yusuke Takahashi ◽  
Masao Okada ◽  
Kaori Hayashibara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Curative Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Rank Test ◽  
Independent Predictive Factor ◽  
Gastric Cancer Patients

295 Background: Several biomarkers based on serum chemistry have been reported to be associated with the prognosis of several types of cancers. This retrospective study aimed to investigate the prognostic value of preoperative mGPS and NLR after curative resection for gastric cancer. Methods: A total of 295 patients who underwent curative gastrectomy for primary gastric cancer at our institution from January 2013 to December 2017 were enrolled in this study. The mGPS was calculated by CRP and Alb using standard thresholds ( > 0.5 mg/dL for CRP and < 3.5 g/dL for Alb). The NLR was defined as absolute neutrophil count divided by absolute lymphocyte count. The survival curves of patients stratified by each parameter were plotted by the Kaplan-Meier method and compared by log-rank test. Multivariate Cox proportional hazards regression models were used to select parameters independently correlated with prognosis. Results: The median follow-up time was 36.7 months, and 29 patients died during follow-up. The estimated 5-year survival rate was 83.1%. Results from the univariate analyses showed mGPS2 (CRP > 0.5 mg/dL and Alb < 3.5 g/dL) was associated with poor survival while NLR and NLRc was not (P < 0.001, P = 0.506, and P = 0.423, respectively). In the multivariate analyses, the mGPS2 was identified as an independent predictive factor for OS in gastric cancer patients after curative resection (HR: 2.624; 95% CI: 1.058-6.505; P = 0.037). Conclusions: Preoperative mGPS2 was associated with worse survival after curative resection of gastric cancer patients. Based on our study, those with mPGS2 may be warranted to receive additional therapy or nutritional support to acquire better survival.

Postoperative Surveillance in Patients With Colorectal Cancer Who Have Undergone Curative Resection: A Prospective, Multicenter, Randomized, Controlled Trial

2006 ◽  
Vol 24 (3) ◽  
pp. 386-393 ◽  
Author(s):  
Francisco Rodríguez-Moranta ◽  
Joan Saló ◽  
Àngels Arcusa ◽  
Jaume Boadas ◽  
Virgínia Piñol ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Tumor Recurrence ◽  
Controlled Trial ◽  
Stage Ii ◽  
Surveillance Strategy ◽  
Postoperative Surveillance ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial

Purpose Although systematic postoperative surveillance of patients with colorectal cancer has been demonstrated to improve survival, it remains unknown whether a more intensive strategy provides any significant advantage. This prospective, multicenter, randomized, controlled trial was aimed at comparing the efficacy of two different surveillance strategies in terms of both survival and recurrence resectability. Patients and Methods Patients with stage II or III colorectal cancer were allocated randomly to either a simple surveillance strategy including clinical evaluation and serum carcinoembryonic antigen monitoring, or an intensive strategy in which abdominal computed tomography or ultrasonography, chest radiograph, and colonoscopy were added. Results A total of 259 patients were included: 132 were observed according to the simple strategy and 127 were observed according to the intensive strategy. Both groups were similar with respect to baseline characteristics and rate and type of tumor recurrence. After a median follow-up of 48 months, there was no difference in the probability of overall survival in the whole series (hazard ratio [HR] = 0.87; 95% CI, 0.49 to 1.54; P = .62). However, the intensive strategy was associated with higher overall survival in patients with stage II tumors (HR = 0.34; 95% CI, 0.12 to 0.98; P = .045) and in those with rectal lesions (HR = 0.09; 95% CI, 0.01 to 0.81; P = .03), mainly due to higher rate of resectability for recurrent tumors. Colonoscopy was responsible for the detection of the highest proportion (44%) of resectable tumor recurrence in the intensive arm. Conclusion A more intensive surveillance strategy improves the prognosis of patients with stage II colorectal cancer or those with rectal tumors. Inclusion of regular performance of colonoscopy seems justified up to the fifth year of follow-up, at least.

scholarly journals Surveillance Program for Diagnosis of HCC in Liver Cirrhosis: Role of Ultrasound Echo Patterns

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Maurizio Soresi ◽  
Antonino Terranova ◽  
Anna Licata ◽  
Antonietta Serruto ◽  
Giuseppe Montalto ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Cumulative Risk ◽  
Liver Function Tests ◽  
Alpha Fetoprotein ◽  
Rank Test ◽  
Surveillance Program ◽  
Ultrasound Screening ◽  
Nodular Pattern

International guidelines suggest ultrasound surveillance for hepatocellular carcinoma (HCC) early diagnosis in liver cirrhosis (LC) patients, but 40% of nodules <2 cm escape detection. We investigated the existence of an ultrasound pattern indicating a higher risk of developing HCC in patients under surveillance. 359 patients with LC (Child-Pugh A-B8) underwent ultrasound screening (median follow-up 54 months, range 12–90 months), liver function tests, alpha-fetoprotein assay, and portal hypertension evaluation. Echo patterns were homogeneous, bright liver, coarse, coarse small nodular pattern, and coarse large nodular pattern. During follow-up 13.9% developed HCC. At multivariate analysis using Cox’s model alpha-fetoprotein, coarse large nodular pattern, portal hypertension, and age were independent predictors of HCC development. Kaplan-Meier estimates of HCC cumulative risk in relation to the baseline echo patterns showed risk of 75% in coarse large nodular pattern patients, 23% coarse small nodular pattern, 21% coarse pattern, 0% homogeneous, and bright liver echo patterns (log-rank test = 23.6, P<0.001). Coarse large nodular pattern indicates a major risk factor for HCC as 40.7% of patients with this pattern developed HCC. Homogeneous and bright liver echo patterns and the absence of portal hypertension were not related to HCC. This observation could raise the question of possibly modifying the follow-up timing in this subset of patients.

Alternatives for the Intensive Follow-Up After Curative Resection of Colorectal Cancer. Potential Novel Biomarkers for the Recommendations

2013 ◽  
Vol 19 (4) ◽  
pp. 619-629 ◽  
Author(s):  
Enikő Orosz ◽  
István Ember ◽  
Katalin Gombos ◽  
László Tóth ◽  
Ádám Tarpay ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Curative Resection ◽  
Novel Biomarkers
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