SURVEILLANCE AFTER COLORECTAL-CANCER SURGERY

Early diagnosis of local and distant recurrences of colorectal cancer remains difficult and there is no agreement on the effectiveness of fo llow-up in these patients, The aim of this study is to assess the valu e of our method of follow-up. We consider 239 patients with colorectal cancer and at Beast 2 years follow-up following radical resection, PI local recurrence appeared in 26 patients (10.9%), a distant metastasi s in 41 (17.1%), while in seven (2.9%) local and distant recurrences a ppeared simultaneously. Local recurrence was detected because of an in crease in carcinoembryonic antigen (CEA) level in 15 patients (57.7%), during a scheduled endoscopy in four (15.4%) and because of symptoms in seven (26.9%), Tn seven patients (26.9%) a radical resection was po ssible, Distant metastases were detected by CEA levels in 20 patients (48.8%), by ultrasonography (U.S.) in 12 (29.3%) and by chest X-ray in five (12.2%). In 13 of 26 patients with liver metastases a resection was performed. This study shows that few patients benefit from follow- up and only CEA levels and liver U.S. performed intensively between 15 and 36 months after surgery are useful in early detection of recurren ces, A modification or the follow-up to the single patient, according to the stage, location and grading of cancer, could improve the result s, so lowering the tests of this expensive practice.