Follow-up of colorectal cancer.

Surveillance for a second primary colon or rectal cancer, detection and treatment of recurrent disease, and health maintenance are the essential components of follow-up of a patient population with potentially curative resection of a primary large bowel cancer. The value of follow-up programs have been extensively studied with colorectal cancer. Of 100 colorectal cancer patients in a follow-up program, approximately 20 patients should have prolongation of life as a result of surveillance, detection and treatment, and health maintenance. Detection of recurrent cancer and its treatment may be the most expensive and least effective part of the follow-up program. Lead time is minimal with intensive follow-up (including serial CEA blood tests) when compared to the time of diagnosis derived from symptoms of recurrent malignancy in an informed patient. Aggressive reoperative surgery in selected patients with recurrent disease with use of adjunctive radiation therapy and chemotherapy when appropriate, will salvage long term the greatest number of people and yield some palliative benefits. It is crucial that reoperative surgery be pursued by an experienced team familiar with this type of intervention. Comprehensive follow-up of colorectal cancer patients has a high value in its medical economic cost and should continue to be pursued, studied, to become more cost effective, and integrated into a complete management plan.