Daniels Anne M, Vogelaar Jeroen F J
Anne M Daniels, Jeroen F J Vogelaar, Department of Surgery, VieCuri Medical Centre, 5912 BL Venlo, The Netherlands.
World J Gastrointest Pathophysiol. 2017 May 15;8(2):96-99. doi: 10.4291/wjgp.v8.i2.96.
According to current guidelines, follow-up of patients with colorectal cancer is ended after five years. Also, chest X-ray is not part of standard investigation during follow-up. We describe a case of a 74-year-old patient, more than ten years after a sigmoid resection because of carcinoma of the sigmoid. No recurrence was detected during intensive follow-up. However, ten years after resection of the sigmoid adenocarcinoma, complaints of coughing induced further examination with as result the detection of a solitary metastasis in the left lung of the patient. Within half-a-year after metastasectomy of the lung metastasis, she presented herself with thoracic pain and dyspnea resulting in discovering diffuse metastasis on pulmonary, pleural, costal and muscular level. Five year follow-up of colorectal carcinoma without chest X-ray can be questioned to be efficient. The growing knowledge of tumor biology might in future adjust the duration and frequency of diagnostic follow-up to prevent (late) recurrence in patients with colorectal carcinoma.
根据现行指南，结直肠癌患者的随访在五年后结束。此外，胸部X光检查并非随访期间标准检查的一部分。我们描述了一例74岁患者的病例，该患者因乙状结肠癌接受乙状结肠切除术后十多年。在密集随访期间未检测到复发。然而，在乙状结肠腺癌切除术后十年，咳嗽症状促使进一步检查，结果在患者左肺发现了一个孤立转移灶。在肺转移灶切除术后半年内，她出现胸痛和呼吸困难，结果发现肺部、胸膜、肋骨和肌肉层面有弥漫性转移。不进行胸部X光检查的结直肠癌五年随访是否有效值得质疑。肿瘤生物学知识的不断增长可能会在未来调整诊断随访的时长和频率，以预防结直肠癌患者（晚期）复发。
