YEARLY COLONOSCOPY, LIVER CT, AND CHEST RADIOGRAPHY DO NOT INFLUENCE 5-YEAR SURVIVAL OF COLORECTAL-CANCER PATIENTS

Background & Aims: Guidelines on the type and frequency of follow-up o f patients after curative surgery for colorectal cancer are unclear. T he aim of this study was to determine the survival benefit of a planne d follow-up program. Methods: Three hundred twenty-five patients who u nderwent curative resection of colorectal cancer were prospectively ra ndomized to either intensive or standard follow-up. After stratificati on according to Dukes' stage and site in the colon or rectum, patients were randomized to intensive follow-up of yearly colonoscopy, compute rized tomography (CT) of the liver, and chest radiography and clinical review and simple screening vs. structured clinical review and simple screening tests only. Results: On completion of 5-year follow-up, the re was no significant difference in survival between the two groups. Y early colonoscopy failed to detect any asymptomatic local recurrences. Only one asymptomatic curable metachronous colon tumor was detected. Liver CT resulted in earlier detection of hepatic metastases but did n ot increase the number of curative hepatectomies. Only 1 patient had a n asymptomatic CT-detected liver metastasis, and another had an asympt omatic chest radiography-detected lung metastasis. Both had curative r esections. Conclusions: Yearly colonoscopy, liver CT, and chest radiog raphy will not improve survival from colorectal cancer when added to s ymptom and simple screening review.