The value of intensive follow-up for patients after resection of colorectal cancer remains controversial.
This study reviews all randomized and prospective cohort studies to assess the value of aggressive follow-up.
The literature was searched from the years 1972 to 1996 for studies reporting on the follow-up of patients with colorectal cancer.
Randomized and comparative-cohort studies that included history, physical examination, and carcinoembrionic antigen values at least three times a year for at least two years were included in a meta-analysis.
Single-cohort studies with intensive follow-up and traditional follow-up were also included in a two-group comparative analysis for each outcome indicator.
Outcome indicators were 1) curative resection rates after recurrent cancer, 2) survival rates of curative re-resections, 3) length of survival after recurrence, and 4) cumulative five-year survival.
Two randomized and three comparative-cohort studies met these criteria and included 2,005 patients, which were evaluated in the meta-analysis.
The cumulative five-year survival was 1.16 times higher in the intensively followed group (P=0.003).
Two and one-half times more curative re-resections were performed for recurrent cancer in those patients undergoing intensive follow-up (P=0.0001).
Those patients in the intensive follow-up group with a recurrence had a 3.62-times higher survival rate than the control (P=0.0004). (...)
Mots-clés Pascal : Carcinome, Côlon, Rectum, Récidive, Etude longitudinale, Métaanalyse, Analyse statistique, Survie, Pronostic, Etats Unis, Amérique du Nord, Amérique, Homme, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Côlon pathologie, Rectum pathologie
Mots-clés Pascal anglais : Carcinoma, Colon, Rectum, Relapse, Follow up study, Metaanalysis, Statistical analysis, Survival, Prognosis, United States, North America, America, Human, Malignant tumor, Digestive diseases, Intestinal disease, Colonic disease, Rectal disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0470572
Code Inist : 002B13B01. Création : 19/02/1999.