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Postsurgical follow-Up. (Clinical Capsules).

Survival was prolonged when patients with colorectal cancer received intensive postoperative follow-up to look for localized recurrences outside the bowel, reported Dr. Andrew G. Renehan of the Christie Hospital NHS Trust in Manchester, England, and his associates.

In this metaanalysis, the investigators reviewed data on 1,342 patients who participated in any of five clinical trials; four of the studies compared intensive follow-up using computerized tomography and measurement of serum carcinoembryonic antigen to look for recurrence outside the bowel and colonoscopy to look for recurrence within the bowel. The fifth trial compared intensive follow-up for bowel recurrence with less rigorous surveillance.

In the first four studies, overall 5-year mortality was 9%-13% lower in the patients who were followed intensively than in those who had standard follow-up. This compared favorably with the 5% survival improvement seen when patients with Dukes' stage C disease received adjuvant therapy (BMJ 324[7341]:813-16, 2002).

Most of the improved survival was due to the 8.5-month earlier detection of local cancer recurrences with intensive surveillance, compared with standard follow-up.
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Title Annotation:colorectal cancer
Author:Kubetin, Sally Koch
Publication:Internal Medicine News
Article Type:Brief Article
Geographic Code:4EUUK
Date:Jun 15, 2002
Previous Article:TIMP-1 enzyme predicts colon cancer prognosis. (Postsurgical Outcome).
Next Article:Easing portal pressure. (Clinical Capsules).

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