Eindhoven Cancer Registry, Comprehensive Cancer Centre South, PO Box 231, 5600 AE Eindhoven, the Netherlands.
Int J Colorectal Dis. 2013 Sep;28(9):1257-65. doi: 10.1007/s00384-013-1693-x. Epub 2013 Apr 28.
The aims of the study were to describe the follow-up of colorectal cancer (CRC) patients in southern Netherlands and examine their overall and disease-free survival.
Patients newly diagnosed with CRC in 2003-2005 and 2008 with a survival of at least 1 year after diagnosis and recorded in the retrospective Eindhoven Cancer Registry were included (n = 579). Follow-up was defined as at least one liver imaging and at least two carcinoembryonic antigen (CEA) measurements. Logistic regression analyses were conducted to assess determinants of follow-up. Proportions of patients undergoing colonoscopy, CEA measurements and liver and chest imaging were calculated. Overall and disease-free survival were calculated.
Patients ≥75 years (odds ratio (OR) 0.5 (95% confidence interval (CI) 0.3-0.7)) were less likely to receive follow-up, contrasting patients <50 years (OR 3.1 (95% CI 1.3-7.4)). In 2008, follow-up intensity increased (OR 2.3 (95% CI 1.2-4.3)), especially for liver imaging and CEA measurements. There were large differences in follow-up intensity and activities between hospitals, which were unaffected by comorbidity: ranges for colonoscopy 15-73 %, CEA measurement 46-91 % and imaging of the liver 22-70 % between hospitals. No effect of follow-up intensity was found on 5-year disease-free survival for patients aged <75 years (64 vs. 68 %; p = 0.6). Similarly, no effect of follow-up intensity on 5-year overall survival was found in these patients (77 vs. 82 %; p = 0.07).
Large variation in follow-up was found for patients with CRC, mainly declining with age and hospital of follow-up. Over time, follow-up became more intensive, especially with respect to liver imaging and CEA measurements. However, follow-up consisting of at least one liver imaging and at least two CEA measurements did not improve overall and disease-free survival.
本研究旨在描述荷兰南部结直肠癌（CRC）患者的随访情况，并评估其总生存和无病生存情况。
本研究纳入了 2003-2005 年和 2008 年新诊断为 CRC、且生存时间至少 1 年的患者（n=579），这些患者的信息均记录在回顾性埃因霍温癌症登记处中。随访定义为至少进行一次肝脏影像学检查和至少两次癌胚抗原（CEA）测量。采用 logistic 回归分析评估随访的决定因素。计算行结肠镜检查、CEA 测量、肝脏和胸部影像学检查的患者比例。计算总生存和无病生存情况。
≥75 岁的患者（比值比（OR）0.5（95%置信区间（CI）0.3-0.7））较<50 岁的患者（OR 3.1（95% CI 1.3-7.4））更不可能接受随访。2008 年，随访强度增加（OR 2.3（95% CI 1.2-4.3）），特别是在肝脏影像学检查和 CEA 测量方面。各医院之间的随访强度和活动存在较大差异，且不受合并症的影响：各医院间结肠镜检查的比例为 15%-73%，CEA 测量的比例为 46%-91%，肝脏影像学检查的比例为 22%-70%。对于<75 岁的患者，随访强度对 5 年无病生存率无影响（64% vs. 68%；p=0.6）。同样，在这些患者中，随访强度对 5 年总生存率也无影响（77% vs. 82%；p=0.07）。
本研究发现 CRC 患者的随访情况存在较大差异，主要与年龄和随访医院有关。随着时间的推移，随访变得更加密集，特别是在肝脏影像学检查和 CEA 测量方面。然而，至少进行一次肝脏影像学检查和至少两次 CEA 测量的随访并未改善总生存和无病生存情况。
