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Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 28, 2007; 13(28): 3816-3823
Published online Jul 28, 2007. doi: 10.3748/wjg.v13.i28.3816
Surveillance of patients following surgery with curative intent for colorectal cancer
Steven Gan, Katherine Wilson, Paul Hollington
Steven Gan, Department of Surgery, St George Hospital, Gray Street, Kogarah, NSW 2217, Australia
Katherine Wilson, Paul Hollington, Department of Surgery, Flinders Medical Centre, Flinders Drive, Bedford Park 5042, Adelaide, Australia
Author contributions: All authors contributed equally to the work.
Correspondence to: Steven Gan, MBBS, FRACS, Department of Surgery, St George Hospital, Gray Street, Kogarah, NSW 2217, Australia. syogan@hotmail.com
Telephone: +61-2-91131111 Fax: +61-2-91131111
Received: May 16, 2007
Revised: May 23, 2007
Accepted: May 28, 2007
Published online: July 28, 2007
Abstract

Surveillance after resection of colorectal cancer with curative intent is an important component of post-operative care. Clinical review, imaging, colonoscopy, and cost to the community are among significant issues to consider in planning a surveillance regime. This review aims to identify the available evidence for the use of surveillance and its individual components. The literature pertaining to follow-up of patients following potentially curative surgery for colorectal cancer was reviewed in order to formulate a summary of the wide range of clinical practice. There is evidence of improved survival of patients undergoing more intense follow-up compared with those having minimal surveillance, with an estimated overall 5-year gain of up to 10%. The efficacy of individual components of follow-up regimes remains unclear, but an overall package of ‘intensive’ follow-up including clinical review, liver imaging, and colonoscopy appears to be of benefit. It is cost-effective and can be specialist or community-based.

Keywords: Colorectal cancer; Colorectal carcinoma; Follow-up; Surveillance; Post-operative review; Post-operative imaging; Post-operative colonoscopy; Surveillance cost benefit