Meyerhardt Jeffrey A, Mayer Robert J
Department of Medical Oncology, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115, USA.
Semin Oncol. 2003 Jun;30(3):349-60. doi: 10.1016/s0093-7754(03)00095-2.
Consensus is lacking as to the best strategy for following patients who have undergone definitive surgical medical treatment for colon cancer. The goal of any surveillance program should be detection of recurrent disease at a sufficiently early time to allow subsequent curative therapy. Although periodic clinical examinations, laboratory tests, radiographic imaging, and carcinoembryonic antigen (CEA) testing have been utilized as a form of surveillance, such aggressive and costly intervention has not been validated through clinical studies. Four of the five randomized trials comparing such an intensive surveillance strategy to less frequent testing have not demonstrated the intensive approach to lead to an improvement in overall survival. Furthermore, intensive testing is both costly and has been shown not to improve quality of life. Further research designing appropriate postoperative testing is needed to guide physicians and patients after the curative resection of a colorectal cancer.
对于接受结肠癌根治性手术治疗的患者，目前缺乏关于最佳随访策略的共识。任何监测计划的目标都应是在足够早的时间发现复发性疾病，以便进行后续的根治性治疗。尽管定期临床检查、实验室检查、影像学检查和癌胚抗原（CEA）检测已被用作一种监测形式，但这种积极且昂贵的干预措施尚未通过临床研究得到验证。五项将这种强化监测策略与较少频率检测进行比较的随机试验中，有四项并未证明强化方法能改善总体生存率。此外，强化检测既昂贵，而且已表明并不能改善生活质量。需要进一步开展研究来设计合适的术后检测方法，以指导结直肠癌根治性切除术后的医生和患者。
