Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2023; 15(12): 2197-2211
Published online Dec 15, 2023. doi: 10.4251/wjgo.v15.i12.2197
Intensive follow-up vs conventional follow-up for patients with non-metastatic colorectal cancer treated with curative intent: A meta-analysis
Li-Li Cui, Shi-Qi Cui, Zhong Qu, Zhen-Qing Ren
Li-Li Cui, Department of Operating Room, Jiangsu Taizhou People’s Hospital, Taizhou 225300, Jiangsu Province, China
Shi-Qi Cui, Department of Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310020, Zhejiang Province, China
Zhong Qu, Department of Endoscopy Center, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310020, Zhejiang Province, China
Zhen-Qing Ren, Department of Nursing, Jiangsu Taizhou People’s Hospital, Taizhou 225300, Jiangsu Province, China
Author contributions: Cui LL and Ren ZQ conceived the study concept and participated in its design, data extraction, statistical analysis; Cui LL, Cui SQ, Qu Z, and Ren ZQ contributed to the manuscript drafting, and editing; Cui SQ and Qu Z participated in the literature research; and all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen-Qing Ren, MA, Department of Nursing, Jiangsu Taizhou People’s Hospital, No. 366 Taihu Road, Pharmaceutical and High-tech Zone, Taizhou 225300, Jiangsu Province, China. 635818285@qq.com
Received: June 21, 2023
Peer-review started: June 21, 2023
First decision: September 6, 2023
Revised: September 22, 2023
Accepted: October 30, 2023
Article in press: October 30, 2023
Published online: December 15, 2023
Processing time: 176 Days and 1.6 Hours
Abstract
BACKGROUND

The frequency and content of follow-up strategies remain controversial for colorectal cancer (CRC), and scheduled follow-ups have limited value.

AIM

To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.

METHODS

PubMed, Embase, and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials (RCTs) from inception until April 2023. The Cochrane risk of bias was used to assess the methodological quality of the included studies. The hazard ratio, relative risk, and 95% confidence interval were used to calculate survival and categorical data, and pooled analyses were performed using the random-effects model. Additional exploratory analyses were performed for sensitivity, subgroups, and publication bias.

RESULTS

Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis. Intensive follow-up may be superior to conventional follow-up in improving overall survival, but this difference was not statistically significant. Moreover, intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up. In addition, there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies, whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up. Finally, the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.

CONCLUSION

Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.

Keywords: Intensive follow-up; Conventional follow-up; Colorectal cancer; Curative intent; Meta-analysis

Core Tip: This systematic review and meta-analysis aimed to determine the effects of intensive vs conventional follow-up strategies on the prognosis of patients with colorectal cancer (CRC) treated with curative intent by examining randomized controlled trials (RCTs). This study found that an intensive follow-up strategy might have beneficial effects on overall survival. Moreover, an intensive follow-up strategy was associated with an increased incidence of salvage surgery and a reduced risk of interval survival. Further large-scale RCTs should assess the effects of intensive follow-up with a specific frequency and content for non-metastatic CRC treated with curative intent.