UNLABELLED: Optimal modalities of surveillance of colorectal cancers (CRC) resected for cure have not been determined so far and the overall improvement of 5-year survival related to surveillance has not been demonstrated. AIM OF THE STUDY: To retrospectively evaluate modalities, results and costs of follow-up of patients during the 5 years following the resection for cure of CRC. METHODS: We studied medical and economical data from records of 256 patients registered in the cancer registry of the Herault area who underwent a potentially curative resection of CRC in 1992. We analyzed comparatively modalities of follow-up in patients who were followed according to recommendations from the 1998 French consensus conference (standard follow-up) and in those who had a simplified follow-up. We evaluated cumulative costs of follow-up. RESULTS: Nine patients died in the postoperative period. Recurrence rate was 27% (69 patients). Sixty-nine patients had a standard follow-up (30% of the 231 classified patients) and 162 patients (70%) had a simplified follow-up. The specific survival rate (taking into account only death related to CRC) 5 years after resection for cure was 75%. The 5-year specific survival rate after diagnosis of recurrence was 12% in the patients with recurrent disease within the 5 years after initial therapy. The 5-year survival rate after standard and simplified follow-up were 85% and 79%, respectively (P=0.25). Total cost of follow-up of the 256 patients was 1 085 507 French francs (FF). Mean follow-up cost per patient was 5 527 FF. Cost of the examinations not recommended by the consensus conference represented 30% of the expenses. Individual total cost of the follow-up of patients alive 5 years after the diagnosis of the recurrence was 120 356 FF. CONCLUSION: In Herault area, clinicians carried out in 70% of the patients a simplified follow-up and in 30% of the cases a reinforced follow-up in comparison with French recommendations. Survival rates were not significantly different between the 2 groups.
UNLABELLED: Optimal modalities of surveillance of colorectal cancers (CRC) resected for cure have not been determined so far and the overall improvement of 5-year survival related to surveillance has not been demonstrated. AIM OF THE STUDY: To retrospectively evaluate modalities, results and costs of follow-up of patients during the 5 years following the resection for cure of CRC. METHODS: We studied medical and economical data from records of 256 patients registered in the cancer registry of the Herault area who underwent a potentially curative resection of CRC in 1992. We analyzed comparatively modalities of follow-up in patients who were followed according to recommendations from the 1998 French consensus conference (standard follow-up) and in those who had a simplified follow-up. We evaluated cumulative costs of follow-up. RESULTS: Nine patients died in the postoperative period. Recurrence rate was 27% (69 patients). Sixty-nine patients had a standard follow-up (30% of the 231 classified patients) and 162 patients (70%) had a simplified follow-up. The specific survival rate (taking into account only death related to CRC) 5 years after resection for cure was 75%. The 5-year specific survival rate after diagnosis of recurrence was 12% in the patients with recurrent disease within the 5 years after initial therapy. The 5-year survival rate after standard and simplified follow-up were 85% and 79%, respectively (P=0.25). Total cost of follow-up of the 256 patients was 1 085 507 French francs (FF). Mean follow-up cost per patient was 5 527 FF. Cost of the examinations not recommended by the consensus conference represented 30% of the expenses. Individual total cost of the follow-up of patients alive 5 years after the diagnosis of the recurrence was 120 356 FF. CONCLUSION: In Herault area, clinicians carried out in 70% of the patients a simplified follow-up and in 30% of the cases a reinforced follow-up in comparison with French recommendations. Survival rates were not significantly different between the 2 groups.