Abstract
Postoperative surveillance for rectal cancer is an important part of comprehensive cancer care. While more effective chemo-radiotherapy and surgical techniques have improved clinical outcomes, risk of recurrent rectal cancer remains high. Long-term surveillance is used to detect recurrent disease that may be potentially resectable and to identify/remove metachronous lesions at an early stage. Surveillance is best accomplished with a combination of clinical exams, laboratory, endoscopic and radiographic tests. Each method has unique strengths and weaknesses, but in totality, and until other biomarkers are identified, they provide the most comprehensive way to surveil postoperative patients with rectal cancer.
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Benson AB 3rd, Venook AP, Bekaii-Saab T, Chan E, Chen YJ, Cooper HS, et al. Rectal cancer, version 2.2015. J Natl Compr Cancer Netw. 2015;13(6):719–28; quiz 28.
Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk ES, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372(14):1324–32.
Green RJ, Metlay JP, Propert K, Catalano PJ, Macdonald JS, Mayer RJ, et al. Surveillance for second primary colorectal cancer after adjuvant chemotherapy: an analysis of intergroup 0089. Ann Intern Med. 2002;136(4):261–9.
Green BL, Marshall HC, Collinson F, Quirke P, Guillou P, Jayne DG, et al. Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg. 2013;100(1):75–82.
Kahi CJ, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colonoscopy surveillance after colorectal cancer resection: recommendations of the US multi-society task force on colorectal cancer. Gastroenterology. 2016;150(3):758–68 e11.
Lieberman DA, Rex DK, Winawer SJ, Giardiello FM, Johnson DA, Levin TR, et al. Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US multi-society task force on colorectal cancer. Gastroenterology. 2012;143(3):844–57.
Lu YY, Chen JH, Chien CR, Chen WT, Tsai SC, Lin WY, et al. Use of FDG-PET or PET/CT to detect recurrent colorectal cancer in patients with elevated CEA: a systematic review and meta-analysis. Int J Color Dis. 2013;28(8):1039–47.
Meyerhardt JA, Mangu PB, Flynn PJ, Korde L, Loprinzi CL, Minsky BD, et al. Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer: American Society of Clinical Oncology clinical practice guideline endorsement. J Clin Oncol. 2013;31(35):4465–70.
Network NCC. Rectal Cancer (Version 2.2019) [August 5, 2019]. Available from: https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.
Pita-Fernandez S, Alhayek-Ai M, Gonzalez-Martin C, Lopez-Calvino B, Seoane-Pillado T, Pertega-Diaz S. Intensive follow-up strategies improve outcomes in nonmetastatic colorectal cancer patients after curative surgery: a systematic review and meta-analysis. Ann Oncol. 2015;26(4):644–56.
Primrose JN, Perera R, Gray A, Rose P, Fuller A, Corkhill A, et al. Effect of 3 to 5 years of scheduled CEA and CT follow-up to detect recurrence of colorectal cancer: the FACS randomized clinical trial. JAMA. 2014;311(3):263–70.
Seo SI, Lim SB, Yoon YS, Kim CW, Yu CS, Kim TW, et al. Comparison of recurrence patterns between </=5 years and > 5 years after curative operations in colorectal cancer patients. J Surg Oncol. 2013;108(1):9–13.
van Gijn W, Marijnen CA, Nagtegaal ID, Kranenbarg EM, Putter H, Wiggers T, et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. Lancet Oncol. 2011;12(6):575–82.
Verberne CJ, Zhan Z, van den Heuvel E, Grossmann I, Doornbos PM, Havenga K, et al. Intensified follow-up in colorectal cancer patients using frequent carcino-embryonic antigen (CEA) measurements and CEA-triggered imaging: results of the randomized “CEAwatch” trial. Eur J Surg Oncol. 2015;41(9):1188–96.
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Chu, D.I., Kennedy, G.D. (2020). Rectal Conditions: Rectal Cancer—Postoperative Surveillance. In: Steele, S., Maykel, J., Wexner, S. (eds) Clinical Decision Making in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-65942-8_42
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DOI: https://doi.org/10.1007/978-3-319-65942-8_42
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