Surveillance of patients following surgery with curative intent for colorectal cancer

Abstract

Surveillance after resection of colorectal cancer with curative intent is an important component of post-operative care. Clinical review, imaging, colonoscopy, and cost to the community are among significant issues to consider in planning a surveillance regime. This review aims to identify the available evidence for the use of surveillance and its individual components. The literature pertaining to follow-up of patients following potentially curative surgery for colorectal cancer was reviewed in order to formulate a summary of the wide range of clinical practice. There is evidence of improved survival of patients undergoing more intense follow-up compared with those having minimal surveillance, with an estimated overall 5-year gain of up to 10%. The efficacy of individual components of follow-up regimes remains unclear, but an overall package of ‘intensive’ follow-up including clinical review, liver imaging, and colonoscopy appears to be of benefit. It is cost-effective and can be specialist or community-based.

Keywords: Colorectal cancer; Colorectal carcinoma; Follow-up; Surveillance; Post-operative review; Post-operative imaging; Post-operative colonoscopy; Surveillance cost benefit