Improved survival after colorectal cancer in patients complying with a postoperative endoscopic surveillance program.

This study investigates whether compliance with a postoperative surveillance program in patients with surgically treated colorectal cancer leads to prolongation of life. The clinical course of 212 patients who had undergone curative resections for colorectal cancer was monitored for at least five years. Eighty-eight patients adhered strictly to a rigid endoscopic surveillance program, and 124 did not. Tumor recurrences occurred in 10% of compliant and 14% of noncompliant patients. Patients with asymptomatic tumor recurrences survived significantly longer (p < 0.05; five-year actuarial survival: 42%) than those who were symptomatic (five-year actuarial survival: 8%). The overall survival rate was significantly higher (p < 0.0002) in compliant patients (five-year actuarial survival: 80%) than in noncompliant patients (five-year actuarial survival: 59%). Noncompliance increased the risk of early death by a factor of 2.5 (95% CI = 1.5; 4.2). It is concluded that postoperative endoscopic surveillance leads to early tumor detection, and is associated with an improvement in survival in patients with colorectal cancer.