Is intensive follow-up really able to improve prognosis of patients with local recurrence after curative surgery for rectal cancer?

Giovanni B. Secco, Roberto Fardelli, Salvatore Rovida, Daniela Gianquinto, Eleonora Baldi, Pierfrancesco Bonfante, Lorenzo Derchi, Romano Ferraris

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Because more than 90% of local recurrences after curative surgery for rectal cancer appear within the first 36 months after surgery, an intensive and strict follow-up program during this period could improve early diagnosis and, thus, prognosis of patients. Methods: Of the 216 patients who underwent surgery for rectal cancer, 127 entered an intensive follow-up program (median follow-up: 42 months); the clinical outcome of the remaining 89 patients was reconstructed with the help of their general practitioners. Results: Fifty eight (26.8%) of the 216 patients who were treated with curative surgery alone developed a local recurrence; pelvic recurrences were prevalent. Eleven (30.5%) of the 36 patients who had recurrence during follow-up, and 6 of the 22 who had not undergone follow-up, had a reoperation with curative intent; the median survival was 19 months vs. 8 months, respectively (P = ns). Four (44.4%) curative reoperations were performed on the 9 asymptomatic patients and in 13 (26.5%) of the 49 cases with symptomatic local recurrences. Median survival was 15 months vs. 14 months, respectively (P = n.s). All patients except one (living after 42 months from reoperation) died within 48 months. Conclusions: In our study, adherence to a strict follow-up program unfortunately proved to be ineffective for improving long-term survival for patients who underwent reoperation with curative intent.

Original languageEnglish
Pages (from-to)32-37
Number of pages6
JournalAnnals of Surgical Oncology
Volume7
Issue number1
Publication statusPublished - Jan 2000

Keywords

  • Intensive follow-up
  • Local recurrence
  • Prognosis
  • Rectal cancer
  • Reoperation

ASJC Scopus subject areas

  • Oncology
  • Surgery

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