Follow-up and rehabilitation still up-to-date? From the point of view of surgical oncology.

The follow-up and aftercare of patients after operation of solid malignanci es serves the purpose of early detection and treatment of recurrences or me tastases. Only in a small part of these patients local recurrences or metas tases can be treated surgically with curative intention. This possibility i s basically available for colorectal cancer, melanoma, soft tissue, osteo-, chondrosarcoma and renal carcinoma. Palliative operations with the chance of increasing the quality of life under consideration of the individual sit uation are meaningful independently of the entity of the tumor. An analysis of the current studies shows that tumor aftercare of most malignancies lea ds to an earlier detection of recurrences but not to an improvement of prog nosis. The effect of the tumor aftercare on the quality of life is not suff iciently evaluated. The tumor aftercare should concentrate on groups of ris k in which the detection of recurrences and metastases leads to a possibili ty of intervention. An inquiry of 103 patients with resected solid tumors s howed that the tumor aftercare is judged positively by the majority and tha t the follow-up of these patients should be performed by the institution of primary therapy or in close cooperation with this hospital. From the point of view of surgical oncology, rehabilitation is especially indicated in ca se of significant underweight, problems of oral food in-take, immobility, n ecessity of psychologic conduct and lacking of domestic care.