Wang Ting, Cui Yi, Huang Wen-Sheng, Deng Yan-Hong, Gong Wei, Li Chu-Jun, Wang Jian-Ping
Gastrointestinal and Anal Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Gastrointest Endosc. 2009 Mar;69(3 Pt 2):609-15. doi: 10.1016/j.gie.2008.05.017. Epub 2009 Jan 10.
Although colonoscopy plays an important role in postoperative surveillance of patients with colorectal cancer, the optimum protocol for colonoscopic surveillance has not been established.
Our purpose was to compare the efficacy of 2 different colonoscopic surveillance strategies in terms of both survival and recurrence resectability.
Prospective, randomized, controlled trial.
A teaching hospital in Sun Yat-sen University.
Three hundred twenty-six consecutive patients undergoing radical surgery for colorectal cancer.
In the intensive colonoscopic surveillance group (ICS group, n = 165), colonoscopy was performed at 3-month intervals for 1 year, at 6-month intervals for the next 2 years, and once a year thereafter. In the routine colonoscopic surveillance group (RCS group, n = 161), colonoscopy was performed at 6 months, 30 months, and 60 months postoperatively.
The 5-year survival rate was 77% in the ICS group and 73% in the RCS group (P > .05). Postoperative colorectal cancer was detected in 13 patients (8.1%) in the ICS group and in 18 patients (11.4%) in the RCS group. In the ICS group, there were more asymptomatic postoperative colorectal cancers (P = .04), more patients had reoperation with curative intent (P = .048), and the probability of survival after postoperative colorectal cancer was higher (P = .03).
Lack of detailed characterization of metachronous colorectal adenomas in these patients.
Although the patients in the ICS group had more curative operations for postoperative colorectal cancer and survived significantly longer, ICS itself did not improve overall survival.
尽管结肠镜检查在结直肠癌患者术后监测中发挥着重要作用，但结肠镜监测的最佳方案尚未确立。
我们的目的是比较两种不同结肠镜监测策略在生存和复发可切除性方面的疗效。
前瞻性、随机、对照试验。
中山大学的一家教学医院。
326例连续接受结直肠癌根治手术的患者。
在强化结肠镜监测组（ICS组，n = 165）中，术后1年每3个月进行1次结肠镜检查，接下来2年每6个月进行1次，此后每年进行1次。在常规结肠镜监测组（RCS组，n = 161）中，术后6个月、30个月和60个月进行结肠镜检查。
ICS组5年生存率为77%，RCS组为73%（P > 0.05）。ICS组13例患者（8.1%）检测到术后结直肠癌，RCS组18例患者（11.4%）检测到。ICS组无症状术后结直肠癌更多（P = 0.04），更多患者进行了根治性再次手术（P = 0.048），术后结直肠癌后的生存概率更高（P = 0.03）。
这些患者中异时性结直肠腺瘤缺乏详细特征描述。
尽管ICS组患者术后结直肠癌的根治性手术更多且生存时间明显更长，但ICS本身并未提高总体生存率。
