Evidence-based follow-up in colorectal  cancer—quo vadis?

SummaryColorectal cancer is the third most common and the third most lethal cancer disease in the western world. As most patients undergo treatment with curative intent at initial diagnosis, postoperative surveillance protocols have been established with the primary aim to detect possible disease recurrence in an early resectable stage. Various international guidelines recommend an intensive surveillance protocol over a  5-year time period. These guidelines are based on the reported significant benefit regarding overall patient survival, and on the observation that 90% of recurrences occur within the first 5 years following resection. Surveillance protocols include regular clinical examinations, measurement of th e carcinoembryonic antigen, computed tomography scans and regular endoscopies. While there is plenty of evidence regarding the scheduling of endoscopies, the frequency of carcinoembryonic antigen measurements and computed tomography scans has been ever since under debate. The benefit of intensive co mpared to low frequency surveillance protocols regarding disease-specific survival has never been shown. Moreover, recent meta-analyses and randomized controlled trials challenge current guidelines. Intensive carcinoembryonic antigen assessment and computed tomography scan follow-up protocols seem t o fail in generating better overall and disease-specific survival in colorectal cancer patients compared to less intensive surveillance strategies. This change over ...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research

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Conclusion This first-in-man study shows that electrochemotherapy for colorectal tumors using the endoscopic electrode device can induce local tumor response and is safe also for fragile elderly patients with comorbidities. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
Conclusions: The finding of advanced colonic neoplasia in follow-up colonoscopy after an acute episode of CT-proven diverticulitis is equivalent to, or less than, that of the population colorectal cancer screening program. Routine colonoscopy is not necessary unless there are other concerning symptoms/CT findings.
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
Surveillance imaging in patients with a history of solid organ malignancies has led to increased identification of asymptomatic adrenal masses, which raises clinical ambiguity in patients with known prior or concurrent malignancies. Single adrenal masses (incidentalomas) are found incidentally in 2%-9% of all abdominal CT scans. Adrenal metastases are most commonly seen in renal cell carcinoma, melanoma, lung cancer, colon cancer and lymphoma. The involvement of adrenal gland upstages the disease.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Tuesday abstract Source Type: research
Authors: Gallo G PMID: 30303703 [PubMed - as supplied by publisher]
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
"Is CT Scan more Accurate than Endoscopy in Identifying Distance from the Anal Verge for Left Sided Colon Cancer? A Comparative Cohort Analysis". J Invest Surg. 2018 Aug 08;:1-8 Authors: Costi R, Ricco' M, Negrini G, Wind P, Violi V, Le Bian AZ Abstract PURPOSES: Accurately localizing colorectal cancer during surgery may be challenging due to intraoperative limitations. In the present study, localization of left-sided colon cancer (LCC) by CT scan is compared to colonoscopy. MATERIAL AND METHODS: Consecutive patients with LCC located by colonoscopy and CT scan and undergoing left-hemicole...
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Colorectal cancer is unique in solid tumor oncology because surgical resection for patients with solitary or oligometastatic disease can provide long-term disease-free survival, and even cure. Largely predicated on the notion that earlier recurrence detection will allow a greater chance of surgery with curative intent, specialty guidelines recommend that patients with stage II or III colorectal cancers should be followed up with a 5-year surveillance program of carcinoembryonic antigen (CEA) testing, computed tomography (CT) scans, and endoscopy. These guidelines are supported by multiple prior studies on the role and sche...
Source: JAMA - Category: General Medicine Source Type: research
AbstractMultiple gastrointestinal cancers in a single patient is a rare entity. In our study, we are showing the clinical presentation and management of these patients. A fifty-nine-year-old asthenic male (already treated case of metachronous colorectal cancer in 2008 and 2011) presented with complaints of generalized weakness and fatigue. Strong family history was present with two of his first-degree relatives having diagnosed with gastrointestinal cancer at the age
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
With an increasing demand for more accurate preoperative staging methods for colon cancer we aimed to compare pre-operative tumour(T)- and nodal(N)-stage in patients with left-sided colonic cancer by endoscopic ultrasonography(EUS) and computed tomography(CT) with post-operative histology as gold standard.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Monday – ASGE poster Source Type: research
Conclusion This case report suggests that great attention should be devoted to post-RYGB patients for an early diagnosis of malignant gastric cancer.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
We present the case of a 43-year-old woman who presented to the emergency department complaining of abdominal pain; fever and rectal bleeding appeared 12 h after a voluntary ‘screening’ colonoscopy. She had no risk factors for CI. Her laboratory tests showed alterations in inflammatory markers and a computed tomography scan showed a circumferential thickening in the left colon and free fluid in the abdomen. After 12 h of observation and conservative therapy, the cli nical state of the patient worsened with the rising of signs of peritonitis. Laparoscopy showed that colon infarction extended from the distal thir...
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research
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