BENEFITS OF COLONOSCOPIC SURVEILLANCE AFTER CURATIVE RESECTION OF COLORECTAL-CANCER

Objective The authors determined the usefulness of routine colonoscopy after colorectal cancer surgery. Summary Background Data Some studies suggest benefit to colonoscopy in the routine follow-up of patients w ith colorectal cancer who are resected for cure, whereas other studies show no benefit. Methods Chart review was conducted for 290 patients who underwent curative resection for colorectal cancer between 1967 an d 1991 at a colorectal surgeon's practice. Colonoscopy was performed e very 6 months during the first year, then every 1 to 2 years, or when intercurrent symptoms appeared. Results Overall, 31 patients (10.7%) d eveloped recurrent disease, which increased as a function of stage (C2 > B2 > A), with a median time to diagnosis of 20 months. Of these 31 recurrences, 14 (45.2%) were solely local (of whom 12 were asymptomati c); 17 (54.8%) involved distant disease. Nine locally recurrent patien ts were able to undergo curative resection. Of 19 symptomatic patients , only 3 (15.8%) were amenable to curative resection. Six patients (2. 1%) developed a metachronous second primary colorectal cancer, of whom four (66.7%) were asymptomatic, and five (83.3%) were able to undergo curative resection. Overall, because of surveillance colonoscopies, 1 3 asymptomatic patients (4.5%) had curative resection for localized re current disease or a metachronous second primary cancer. Conclusions C olonoscopy is a useful modality in the early detection of recurrent an d metachronous disease after colorectal cancer, increasing the potenti al for curative resection and improved survival.