Role of surveillance imaging and endoscopy in colorectal cancer follow-up:Quality over quantity?
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摘要
Colorectal cancer(CRC) is a prevalent disease and represents a major cause of morbidity and mortality in the developed world. Intensive post-treatment surveillance is routinely recommended by major expert groups for early stage(Ⅱ and Ⅲ) CRC survivors because previous meta-analyses showed a modest, but significant survival benefit. This practice has been recently challenged based on data emerging from several large phase Ⅲ randomized trials that demonstrated a lack of survival benefit from intensive surveillance strategies. In addition,findings from cost-effectiveness analyses of such an approach are inconsistent.Data on real-world practice, specifically adherence to these follow-up guidelines,are also limited. The debate is especially controversial in resected stage Ⅳ patients where there are currently no clear guidelines for follow-up. In an era of personalized medicine, there may be a shift towards a more risk-adapted approach to better define the optimal follow-up strategy. In this article, we review the evidence and highlight the role of surveillance in CRC survivors.
Colorectal cancer(CRC) is a prevalent disease and represents a major cause of morbidity and mortality in the developed world. Intensive post-treatment surveillance is routinely recommended by major expert groups for early stage(Ⅱ and Ⅲ) CRC survivors because previous meta-analyses showed a modest, but significant survival benefit. This practice has been recently challenged based on data emerging from several large phase Ⅲ randomized trials that demonstrated a lack of survival benefit from intensive surveillance strategies. In addition,findings from cost-effectiveness analyses of such an approach are inconsistent.Data on real-world practice, specifically adherence to these follow-up guidelines,are also limited. The debate is especially controversial in resected stage Ⅳ patients where there are currently no clear guidelines for follow-up. In an era of personalized medicine, there may be a shift towards a more risk-adapted approach to better define the optimal follow-up strategy. In this article, we review the evidence and highlight the role of surveillance in CRC survivors.
Colorectal cancer(CRC) is a prevalent disease and represents a major cause of morbidity and mortality in the developed world. Intensive post-treatment surveillance is routinely recommended by major expert groups for early stage(Ⅱ and Ⅲ) CRC survivors because previous meta-analyses showed a modest, but significant survival benefit. This practice has been recently challenged based on data emerging from several large phase Ⅲ randomized trials that demonstrated a lack of survival benefit from intensive surveillance strategies. In addition,findings from cost-effectiveness analyses of such an approach are inconsistent.Data on real-world practice, specifically adherence to these follow-up guidelines,are also limited. The debate is especially controversial in resected stage Ⅳ patients where there are currently no clear guidelines for follow-up. In an era of personalized medicine, there may be a shift towards a more risk-adapted approach to better define the optimal follow-up strategy. In this article, we review the evidence and highlight the role of surveillance in CRC survivors.
引文
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2 Ferlay J,Soerjomataram I,Dikshit R,Eser S,Mathers C,Rebelo M,Parkin DM,Forman D,Bray F.Cancer incidence and mortality worldwide:sources,methods and major patterns in GLOBOCAN 2012.Int J Cancer 2015;136:E359-E386[PMID:25220842 DOI:10.1002/ijc.29210]
3 Kjeldsen BJ,Kronborg O,Fenger C,J?rgensen OD.A prospective randomized study of followup after radical surgery for colorectal cancer.Br J Surg 1997;84:666-669[PMID:9171758 DOI:10.1002/bjs.1800840523]
4 Pfister DG,Benson AB 3rd,Somerfield MR.Clinical practice.Surveillance strategies after curative treatment of colorectal cancer.N Engl J Med 2004;350:2375-2382[PMID:15175439 DOI:10.1056/NEJMcp010529]
5 O'Connell MJ,Campbell ME,Goldberg RM,Grothey A,Seitz JF,Benedetti JK,AndréT,Haller DG,Sargent DJ.Survival following recurrence in stage II and III colon cancer:findings from the ACCENT data set.J Clin Oncol 2008;26:2336-2341[PMID:18467725 DOI:10.1200/JCO.2007.15.8261]
6 Morris EJ,Forman D,Thomas JD,Quirke P,Taylor EF,Fairley L,Cottier B,Poston G.Surgical management and outcomes of colorectal cancer liver metastases.Br J Surg 2010;97:1110-1118[PMID:20632280 DOI:10.1002/bjs.7032]
7 Kahi CJ,Boland CR,Dominitz JA,Giardiello FM,Johnson DA,Kaltenbach T,Lieberman D,Levin TR,Robertson DJ,Rex DK;United States Multi-Society Task Force on Colorectal Cancer.Colonoscopy Surveillance After Colorectal Cancer Resection:Recommendations of the US Multi-Society Task Force on Colorectal Cancer.Gastroenterology 2016;150:758-768.e11[PMID:26892199 DOI:10.1053/j.gastro.2016.01.001]
8 Baca B,Beart RW Jr,Etzioni DA.Surveillance after colorectal cancer resection:a systematic review.Dis Colon Rectum 2011;54:1036-1048[PMID:21730795 DOI:10.1007/DCR.0b013e31820db364]
9 Shah M,Denlinger CS.Optimal post-treatment surveillance in cancer survivors:is more really better?Oncology(Williston Park)2015;29:230-240[PMID:25952485]
10 Mokhles S,Macbeth F,Farewell V,Fiorentino F,Williams NR,Younes RN,Takkenberg JJ,Treasure T.Meta-analysis of colorectal cancer follow-up after potentially curative resection.Br JSurg 2016;103:1259-1268[PMID:27488593 DOI:10.1002/bjs.10233]
11 Wille-J?rgensen P,Syk I,Smedh K,Laurberg S,Nielsen DT,Petersen SH,Renehan AG,Horváth-PuhóE,P?hlman L,S?rensen HT;COLOFOL Study Group.Effect of More vs Less Frequent Follow-up Testing on Overall and Colorectal Cancer-Specific Mortality in Patients With Stage II or III Colorectal Cancer:The COLOFOL Randomized Clinical Trial.JAMA 2018;319:2095-2103[PMID:29800179 DOI:10.1001/jama.2018.5623]
12 Snyder RA,Hu CY,Cuddy A,Francescatti AB,Schumacher JR,Van Loon K,You YN,Kozower BD,Greenberg CC,Schrag D,Venook A,McKellar D,Winchester DP,Chang GJ;Alliance for Clinical Trials in Oncology Network Cancer Surveillance Optimization Working Group.Association Between Intensity of Posttreatment Surveillance Testing and Detection of Recurrence in Patients With Colorectal Cancer.JAMA 2018;319:2104-2115[PMID:29800181 DOI:10.1001/jama.2018.5816]
13 Pita-Fernández S,Alhayek-AíM,González-Martín C,López-Calvi?o B,Seoane-Pillado T,Pértega-Díaz S.Intensive follow-up strategies improve outcomes in nonmetastatic colorectal cancer patients after curative surgery:a systematic review and meta-analysis.Ann Oncol 2015;26:644-656[PMID:25411419 DOI:10.1093/annonc/mdu543]
14 Meyerhardt JA,Mangu PB,Flynn PJ,Korde L,Loprinzi CL,Minsky BD,Petrelli NJ,Ryan K,Schrag DH,Wong SL,Benson AB 3rd;American Society of Clinical Oncology.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;31:4465-4470[PMID:24220554 DOI:10.1200/JCO.2013.50.7442]
15 Labianca R,Nordlinger B,Beretta GD,Mosconi S,MandalàM,Cervantes A,Arnold D;ESMOGuidelines Working Group.Early colon cancer:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up.Ann Oncol 2013;24 Suppl 6:vi64-vi72[PMID:24078664 DOI:10.1093/annonc/mdt354]
16 Glimelius B,Tiret E,Cervantes A,Arnold D;ESMO Guidelines Working Group.Rectal cancer:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up.Ann Oncol2013;24 Suppl 6:vi81-vi88[PMID:24078665 DOI:10.1093/annonc/mdt240]
17 Benson AB 3rd,Venook AP,Al-Hawary MM,Cederquist L,Chen YJ,Ciombor KK,Cohen S,Cooper HS,Deming D,Engstrom PF,Garrido-Laguna I,Grem JL,Grothey A,Hochster HS,Hoffe S,Hunt S,Kamel A,Kirilcuk N,Krishnamurthi S,Messersmith WA,Meyerhardt J,Miller ED,Mulcahy MF,Murphy JD,Nurkin S,Saltz L,Sharma S,Shibata D,Skibber JM,Sofocleous CT,Stoffel EM,Stotsky-Himelfarb E,Willett CG,Wuthrick E,Gregory KM,Freedman-Cass DA.NCCN Guidelines Insights:Colon Cancer,Version 2.2018.J Natl Compr Canc Netw 2018;16:359-369[PMID:29632055 DOI:10.6004/jnccn.2018.0021]
18 Rex DK,Kahi CJ,Levin B,Smith RA,Bond JH,Brooks D,Burt RW,Byers T,Fletcher RH,Hyman N,Johnson D,Kirk L,Lieberman DA,Levin TR,O'Brien MJ,Simmang C,Thorson AG,Winawer SJ.Guidelines for colonoscopy surveillance after cancer resection:a consensus update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer.CA Cancer J Clin2006;56:160-167;quiz 185-186[PMID:16737948 DOI:10.1053/j.gastro.2006.03.013]
19 Hassan C,Pickhardt PJ,Zullo A,Di Giulio E,Laghi A,Kim DH,Iafrate F.Cost-effectiveness of early colonoscopy surveillance after cancer resection.Dig Liver Dis 2009;41:881-885[PMID:19467938 DOI:10.1016/j.dld.2009.03.016]
20 Tjandra JJ,Chan MK.Follow-up after curative resection of colorectal cancer:a meta-analysis.Dis Colon Rectum 2007;50:1783-1799[PMID:17874269 DOI:10.1007/s10350-007-9030-5]
21 Jeffery M,Hickey BE,Hider PN.Follow-up strategies for patients treated for non-metastatic colorectal cancer.Cochrane Database Syst Rev 2007;CD002200[PMID:17253476 DOI:10.1002/14651858.CD002200.pub2]
22 Rosati G,Ambrosini G,Barni S,Andreoni B,Corradini G,Luchena G,Daniele B,Gaion F,Oliverio G,Duro M,Martignoni G,Pinna N,Sozzi P,Pancera G,Solina G,Pavia G,Pignata S,Johnson F,Labianca R,Apolone G,Zaniboni A,Monteforte M,Negri E,Torri V,Mosconi P,Fossati R;GILDA working group.A randomized trial of intensive versus minimal surveillance of patients with resected Dukes B2-C colorectal carcinoma.Ann Oncol 2016;27:274-280[PMID:26578734 DOI:10.1093/annonc/mdv541]
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