Systematic follow-up after curative surgery for colorectal cancer in Norway:: A population-based audit of effectiveness, costs, and compliance
Systematic follow-up after curative surgery for colorectal cancer in Norway:: A population-based audit of effectiveness, costs, and compliance
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DOI：
10.1016/j.gassur.2004.09.023
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发表时间：
2005-03-01
影响因子：
3.2
通讯作者：
Söreide, JA
中科院分区：
文献类型：
--
作者：
Körner, H;Söreide, K;Söreide, JA
在这项研究中，我们分析了挪威的指南，在一个大型的单一机构根治性结直肠癌手术后的系统随访。1996年至1999年间，我们对314例连续接受结直肠癌根治性手术的直肠癌患者的无症状可治愈复发、依从性和费用进行了研究。随访包括癌胚抗原（CEA）间期测量、结肠镜检查、肝脏超声检查和胸部X线摄影。在194例（62%）患者中，根据挪威指南进行随访。21例患者（11%）因可治愈复发而接受手术，18例患者（9%）在评价时因复发而接受根治性手术后无疾病。发现4例异时性肿瘤（2%），CEA间期测定最常用于发现1例无症状可治愈复发（需要534次检测）。随访计划不影响癌症特异性生存率。监测计划的总体依从性为66%，结肠镜检查的依从性最低（55%），肝脏超声检查的依从性最高（85%）。该方案的总费用为228，117美元（280，994美元），转化为20，530美元（25，289美元），用于一名复发手术后存活的患者。术后复发的无病生存率的总诊断率为9%。依从性中等。是否继续实施这样的计划和成本是合理的，应该进行辩论。(c)2005年消化道外科学会
In this study, we analyzed the Norwegian guidelines for systematic follow-up after curative colorectal cancer surgery in a large single institution. Three hundred fourteen consecutive unselected patients undergoing curative surgery for colorectal cancer between 1996 and 1999 were studied with regard to asymptomatic curable recurrence, compliance with the program, and cost. Follow-up included carcinoembryonic antigen (CEA) interval measurements, colonoscopy, ultrasonography of the liver, and radiography of the chest. In 194 (62%) of the patients, follow-up was conducted according to the Norwegian guidelines. Twenty-one patients (11%) were operated on for curable recurrence, and 18 patients (9%) were disease free after curative surgery for recurrence at evaluation. Four metachronous tumors (2%) were found. CEA interval measurement had to be made most frequently (534 tests needed) to detect one asymptomatic curable recurrence. Follow-up program did not influence cancer-specific survival. Overall compliance with the surveillance program was 66%, being lowest for colonoscopy (55%) and highest for ultrasonography of the liver (85%). The total program cost was 228,117 (US $ 280,994), translating into 20,530 (US $ 25,289) for one surviving patient after surgery for recurrence. The total diagnosis yield with regard to disease-free survival after surgery for recurrence was 9%. Compliance was moderate. Whether the continuing implementation of such program and cost are justified should be debated. (c) 2005 The Society for Surgery of the Alimentary Tract