Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline
Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline
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DOI：
10.1200/jco.2005.04.0063
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发表时间：
2005-11-20
影响因子：
45.3
通讯作者：
Petrelli, NJ
中科院分区：
文献类型：
--
作者：
Desch, CE;Benson, A;Petrelli, NJ
目的更新2000年美国临床肿瘤学会关于结直肠癌监测的指南。建议基于三项独立报道的随机对照试验的荟萃分析结果，这些试验比较了低强度和高强度的结直肠癌监测方案，以及最近对结肠癌和直肠癌主要临床试验数据的分析，专家组建议，对于复发风险较高且可能接受治疗性手术的患者，在初次治疗后3年内每年进行胸部和腹部计算机断层扫描（CT）;盆腔CT扫描用于直肠癌监测，特别是对于有几个不良预后因素的患者，包括那些没有接受放射治疗的患者;手术治疗后3年进行结肠镜检查，如果结果正常，此后每5年进行一次;对于未接受盆腔放射治疗的直肠癌患者，每6个月进行一次柔性原乙状结肠镜检查，持续5年;病史和体格检查，前3年每3至6个月一次，第4年和第5年每6个月一次，随后由医生酌情决定;和癌胚抗原，如果患者是手术或全身治疗的候选人，则在诊断后至少3年内，术后每3个月进行一次。不建议进行胸部X光、CBC和肝功能检查，分子或细胞标志物不应影响基于现有证据的监测策略。
Purpose To update the 2000 American Society of Clinical Oncology guideline on colorectal cancer surveillance.Recommendations Based on results from three independently reported meta-analyses of randomized controlled trials that compared low-intensity and high-intensity programs of colorectal cancer surveillance, and on recent analyses of data from major clinical trials in colon and rectal cancer, the Panel recommends annual computed tomography (CT) of the chest and abdomen for 3 years after primary therapy for patients who are at higher risk of recurrence and who could be candidates for curative-intent surgery; pelvic CT scan for rectal cancer surveillance, especially for patients with several poor prognostic factors, including those who have not been treated with radiation; colonoscopy at 3 years after operative treatment, and, if results are normal, every 5 years thereafter; flexible protosigmoicloscopy every 6 months for 5 years for rectal cancer patients who have not been treated with pelvic radiation; history and physical examination every 3 to 6 months for the first 3 years, every 6 months during years 4 and 5, and subsequently at the discretion of the physician; and carcinoembryonic antigen every 3 months postoperatively for at least 3 years after diagnosis, if the patient is a candidate for surgery or systemic therapy. Chest x-rays, CBCs, and liver function tests are not recommended, and molecular or cellular markers should not influence the surveillance strategy based on available evidence.