Buie W Donald, Attard Jo-Anne P
Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
Clin Colon Rectal Surg. 2005 Aug;18(3):232-43. doi: 10.1055/s-2005-916284.
Recent evidence suggests that intensive follow-up after curative resection of colorectal cancer is associated with a small but significant improvement in survival. Regimens that employ cross-sectional imaging and carcinoembryonic antigen determination appear to have the greatest benefit. A risk-adapted approach to follow-up, intensively following patients at highest risk of recurrence, increases efficacy and cost-effectiveness. Ongoing improvements in risk stratification, disease detection, and treatment will increase the benefits of postoperative surveillance. Large randomized controlled trials are needed to determine the optimal surveillance regimen and must include an analysis of survival, quality of life, and cost-effectiveness to assess efficacy properly.
最近的证据表明,结直肠癌根治性切除术后的强化随访与生存率的小幅但显著提高相关。采用横断面成像和癌胚抗原测定的方案似乎具有最大益处。一种风险适应性随访方法,即对复发风险最高的患者进行强化随访,可提高疗效和成本效益。风险分层、疾病检测和治疗方面的持续改进将增加术后监测的益处。需要进行大型随机对照试验以确定最佳监测方案,并且必须包括对生存率、生活质量和成本效益的分析,以正确评估疗效。