[法国埃罗省接受根治性切除的结直肠癌患者随访情况。一项医疗经济学研究]

Borie F, Daurès J P, Millat B, Folschveiller-Bruggeman M, Trétarre B

Service de Chirurgie Digestive A, Hôpital Saint-Eloi, Montpellier, France.

Gastroenterol Clin Biol. 2001 Oct;25(10):881-4.

UNLABELLED

Optimal modalities of surveillance of colorectal cancers (CRC) resected for cure have not been determined so far and the overall improvement of 5-year survival related to surveillance has not been demonstrated.

AIM OF THE STUDY

To retrospectively evaluate modalities, results and costs of follow-up of patients during the 5 years following the resection for cure of CRC.

METHODS

We studied medical and economical data from records of 256 patients registered in the cancer registry of the Herault area who underwent a potentially curative resection of CRC in 1992. We analyzed comparatively modalities of follow-up in patients who were followed according to recommendations from the 1998 French consensus conference (standard follow-up) and in those who had a simplified follow-up. We evaluated cumulative costs of follow-up.

RESULTS

Nine patients died in the postoperative period. Recurrence rate was 27% (69 patients). Sixty-nine patients had a standard follow-up (30% of the 231 classified patients) and 162 patients (70%) had a simplified follow-up. The specific survival rate (taking into account only death related to CRC) 5 years after resection for cure was 75%. The 5-year specific survival rate after diagnosis of recurrence was 12% in the patients with recurrent disease within the 5 years after initial therapy. The 5-year survival rate after standard and simplified follow-up were 85% and 79%, respectively (P=0.25). Total cost of follow-up of the 256 patients was 1 085 507 French francs (FF). Mean follow-up cost per patient was 5 527 FF. Cost of the examinations not recommended by the consensus conference represented 30% of the expenses. Individual total cost of the follow-up of patients alive 5 years after the diagnosis of the recurrence was 120 356 FF.

CONCLUSION

In Herault area, clinicians carried out in 70% of the patients a simplified follow-up and in 30% of the cases a reinforced follow-up in comparison with French recommendations. Survival rates were not significantly different between the 2 groups.

未标注

目前尚未确定用于治愈性切除的结直肠癌（CRC）的最佳监测方式，且与监测相关的5年生存率的整体改善尚未得到证实。

研究目的

回顾性评估CRC治愈性切除术后5年内患者的随访方式、结果及费用。

方法

我们研究了1992年在埃罗省癌症登记处登记的256例接受了CRC潜在治愈性切除的患者记录中的医学和经济数据。我们比较分析了根据1998年法国共识会议建议进行随访的患者（标准随访）和进行简化随访的患者的随访方式。我们评估了随访的累积费用。

结果

9例患者在术后死亡。复发率为27%（69例患者）。69例患者进行了标准随访（占231例分类患者的30%），162例患者（70%）进行了简化随访。治愈性切除术后5年的特定生存率（仅考虑与CRC相关的死亡）为75%。初始治疗后5年内复发疾病患者复发诊断后5年的特定生存率为12%。标准随访和简化随访后的5年生存率分别为85%和79%（P = 0.25）。256例患者的随访总费用为1 085 507法国法郎（FF）。每位患者的平均随访费用为5 527 FF。共识会议未推荐的检查费用占总费用的30%。复发诊断后存活5年的患者的个体随访总费用为120 356 FF。