Alice Frontali1, Benjamin Benichou1, Ionut Valcea1, Léon Maggiori1, Justine Prost À la Denise1, Yves Panis2. 1. Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif (PMAD), Hôpital Beaujon-Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, Clichy, 92110, France. 2. Service de Chirurgie Colorectale, Pôle des Maladies de l'Appareil Digestif (PMAD), Hôpital Beaujon-Assistance Publique des Hôpitaux de Paris (APHP), Université Paris VII (Denis Diderot), 100 boulevard du Général Leclerc, Clichy, 92110, France. yves.panis@aphp.fr.
Abstract
PURPOSE: The aim of this study was to assess if to prolong follow-up (FU) more than 5 years after surgery for colorectal cancer (CRC) is justified or not. METHODS: Patients who underwent surgery for a CRC before 2013 and without any tumor recurrence (or synchronous metastases) during the first 5 years after surgery were identified from our database and included. RESULTS: Between 1996 and 2012, 121 patients operated for rectal (RC) (median of FU of 84 months; range 60-211) and 97 with colonic cancer (CC) (median of FU of 78 months; range 60-139), without any tumor recurrence (or synchronous metastases) during the first 5 years after surgery, presented a late tumor recurrence: 13/121 RC (10.7%) versus 2/97 CC (2.1%) (p = 0.014); 8/13 recurrences in RC (61.5%) were observed after neoadjuvant radiochemotherapy, and 9/13 (69.2%) in pN0 tumors. Among the 13 recurrences, 3 had both local and metastatic recurrences (23%), 5 an isolated local recurrence (38.5%) and 5 an isolated metastatic recurrence (38.5%). After surgery for CC, the 2 recurrences were observed in patients with T3N0 tumors. CONCLUSION: After surgery for a CRC, in patients without tumor recurrence during the first 5 years after surgery, follow-up after 5 years must be continued in rectal cancer patients because of a 10.7% rate of late recurrence. On the opposite, after surgery for colon cancer the 2% rate of late recurrence after 5 years suggested that only patients with pT3-T4 colonic cancer could probably be followed more than 5 years after surgery.
PURPOSE: The aim of this study was to assess if to prolong follow-up (FU) more than 5 years after surgery for colorectal cancer (CRC) is justified or not. METHODS:Patients who underwent surgery for a CRC before 2013 and without any tumor recurrence (or synchronous metastases) during the first 5 years after surgery were identified from our database and included. RESULTS: Between 1996 and 2012, 121 patients operated for rectal (RC) (median of FU of 84 months; range 60-211) and 97 with colonic cancer (CC) (median of FU of 78 months; range 60-139), without any tumor recurrence (or synchronous metastases) during the first 5 years after surgery, presented a late tumor recurrence: 13/121 RC (10.7%) versus 2/97 CC (2.1%) (p = 0.014); 8/13 recurrences in RC (61.5%) were observed after neoadjuvant radiochemotherapy, and 9/13 (69.2%) in pN0 tumors. Among the 13 recurrences, 3 had both local and metastatic recurrences (23%), 5 an isolated local recurrence (38.5%) and 5 an isolated metastatic recurrence (38.5%). After surgery for CC, the 2 recurrences were observed in patients with T3N0 tumors. CONCLUSION: After surgery for a CRC, in patients without tumor recurrence during the first 5 years after surgery, follow-up after 5 years must be continued in rectal cancerpatients because of a 10.7% rate of late recurrence. On the opposite, after surgery for colon cancer the 2% rate of late recurrence after 5 years suggested that only patients with pT3-T4 colonic cancer could probably be followed more than 5 years after surgery.