AIM To analyze the diagnostic performance of surveillance colonoscopy,computed tomography(CT),and tumor markers(TMs)in detecting CRC recurrence or metastasis during follow-up after CRC resection.Secondary objectives i...AIM To analyze the diagnostic performance of surveillance colonoscopy,computed tomography(CT),and tumor markers(TMs)in detecting CRC recurrence or metastasis during follow-up after CRC resection.Secondary objectives included degree of adherence to clinical practice guidelines surveillance recommendations and factors associated with adherence and all-cause and CRC mortality.METHODS The single-center retrospective cohort study including patients undergoing curative resection of stage I-III CRC during 2010-2015.Follow-up was performed using TMs every 6 months,yearly CT for 5 years,and colonoscopy at years 1 and 4.Demographic,primary tumor data,and results at follow-up were collected.RESULTS Of 574 included patients included,153 had recurrences or metastases.Of this group,136(88.9%)were diagnosed by CT,10(6.5%)by CT and colonoscopy,and 7(4.6%)by colonoscopy;only 67.8%showed TMs elevation.Adherence to follow-up recommendations was 68.8%for the first colonoscopy,74%for the first CT scan,and 96.6%for the first blood test;these values declined over time.Younger age at diagnosis[odds ratio(OR)0.93;95%CI:0.91-0.95],CRC stages I-II(OR 0.38;95%CI:0.24-0.61),and adherence to follow-up recommendations(OR 0.30;95%CI:0.20-0.46)were independently associated with lower risk for all-cause death at 5 years.CONCLUSION CT scan had the highest diagnostic yield.Adherence to follow-up recommendations was low and decreased during follow-up.Younger age at diagnosis,stage,and follow-up adherence were associated with lower 5-year mortality.展开更多
基金Supported by Instituto de Investigación Sanitaria ISABIAL,No.P42022-0275.
文摘AIM To analyze the diagnostic performance of surveillance colonoscopy,computed tomography(CT),and tumor markers(TMs)in detecting CRC recurrence or metastasis during follow-up after CRC resection.Secondary objectives included degree of adherence to clinical practice guidelines surveillance recommendations and factors associated with adherence and all-cause and CRC mortality.METHODS The single-center retrospective cohort study including patients undergoing curative resection of stage I-III CRC during 2010-2015.Follow-up was performed using TMs every 6 months,yearly CT for 5 years,and colonoscopy at years 1 and 4.Demographic,primary tumor data,and results at follow-up were collected.RESULTS Of 574 included patients included,153 had recurrences or metastases.Of this group,136(88.9%)were diagnosed by CT,10(6.5%)by CT and colonoscopy,and 7(4.6%)by colonoscopy;only 67.8%showed TMs elevation.Adherence to follow-up recommendations was 68.8%for the first colonoscopy,74%for the first CT scan,and 96.6%for the first blood test;these values declined over time.Younger age at diagnosis[odds ratio(OR)0.93;95%CI:0.91-0.95],CRC stages I-II(OR 0.38;95%CI:0.24-0.61),and adherence to follow-up recommendations(OR 0.30;95%CI:0.20-0.46)were independently associated with lower risk for all-cause death at 5 years.CONCLUSION CT scan had the highest diagnostic yield.Adherence to follow-up recommendations was low and decreased during follow-up.Younger age at diagnosis,stage,and follow-up adherence were associated with lower 5-year mortality.
