IMPROVED SURVIVAL AFTER COLORECTAL-CANCER IN PATIENTS COMPLYING WITH A POSTOPERATIVE ENDOSCOPIC SURVEILLANCE PROGRAM

This study investigates whether compliance with a postoperative survei llance program in patients with surgically treated colorectal cancer l eads to prolongation of life. The clinical course of 212 patients who had undergone curative resections for colorectal cancer was monitored for at least five years. Eighty-eight patients adhered strictly to a r igid endoscopic surveillance program, and 124 did not. Tumor recurrenc es occurred in 10% of compliant and 14% of noncompliant patients. Pati ents with asymptomatic tumor recurrences survived significantly longer (p < 0.05; five-year actuarial survival: 42%) than those who were sym ptomatic (five-gear actuarial survival: 8%). The overall survival rate was significantly higher (p < 0.0002) in compliant patients (five-yea r actuarial survival: 80%) than in noncompliant patients (five-year ac tuarial survival: 59%). Noncompliance increased the risk of early deat h by a factor of 2.5 (95% CI = 1.5; 4.2). It is concluded that postope rative endoscopic surveillance leads to early tumor detection, and is associated with an improvement in survival in patients with colorectal cancer.