Kjeldsen B J, Kronborg O, Fenger C, Jørgensen O D
Department of Surgery A, Odense University Hospital, Denmark.
Int J Colorectal Dis. 1997;12(6):329-34. doi: 10.1007/s003840050118.
In a prospective randomised study, 597 patients subjected to curative surgery for colorectal cancer were allocated to either a group with frequent follow-up or a control group with follow-up every 5 years. The pattern of recurrence is reviewed. An equal number of recurrences was detected in the two groups, but the recurrence was diagnosed 9 months earlier in patients followed frequently, and the diagnostic characteristics of various tests dependent upon how often they were used. It is unlikely that frequent follow-up after curative surgery for colorectal cancer has a large positive influence upon survival, but a small benefit from an intensive follow-up program cannot be ruled out. The present results indicate that clinical examination, digital rectal examination, proctoscopy, colonoscopy and chest x-ray should be included in such a programme, whereas others (blood haemoglobin, faecal occult blood test, double contrast braium enema, serum alanine aminotransferase, and serum bilirubin) should be avoided, having a low sensitivity for detecting recurrent colorectal cancer.
在一项前瞻性随机研究中，597例接受结直肠癌根治性手术的患者被分为随访频繁组或每5年随访一次的对照组。对复发模式进行了回顾。两组检测到的复发例数相等，但随访频繁的患者复发诊断提前了9个月，且各种检查的诊断特征取决于其使用频率。结直肠癌根治性手术后频繁随访对生存不太可能有很大的积极影响，但不能排除强化随访方案有小的益处。目前的结果表明，这样的方案应包括临床检查、直肠指检、直肠镜检查、结肠镜检查和胸部X线检查，而其他检查（血红蛋白、粪便潜血试验、双重对比钡灌肠、血清丙氨酸转氨酶和血清胆红素）应避免使用，因为它们对检测复发性结直肠癌的敏感性较低。
