RT Journal Article
SR Electronic
T1 Symptomatic and Asymptomatic Colon Cancer Recurrence: A Multicenter Cohort Study
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 215
OP 220
DO 10.1370/afm.1919
VO 14
IS 3
A1 Laura A. M. Duineveld
A1 Kristel M. van Asselt
A1 Willem A. Bemelman
A1 Anke B. Smits
A1 Pieter J. Tanis
A1 Henk C. P. M. van Weert
A1 Jan Wind
YR 2016
UL http://www.annfammed.org/content/14/3/215.abstract
AB PURPOSE Follow-up after colorectal cancer treatment with curative intent aims to detect recurrences and metachronous tumors in a timely manner. The objective of this study is to assess how recurrent disease presents and is diagnosed within scheduled follow-up according to the national guideline for the Netherlands.METHODS In a retrospective study of consecutive patients with colorectal cancer who were treated in 2 hospitals in the Netherlands, we identified patients with colon cancer who underwent surgery with curative intent between January 2007 and December 2012. Patients who developed recurrent disease were included for further analyses.RESULTS From a total of 446 patients who were been treated for colon carcinoma with curative intent, 74 developed recurrent disease (17%). In 43 of those patients (58%), recurrent disease was detected during a scheduled follow-up visit, with 41 (95%) being asymptomatic. Tumor marker testing, imaging, and colonoscopy identified all of these recurrences. In the remaining 31 patients with recurrent disease (42%), recurrence was found during non-scheduled interval visits; 26 (84%) of these patients were symptomatic. The most prevalent symptoms were abdominal pain, altered defecation, and weight loss. Patients with asymptomatic recurrences had a significantly higher overall survival compared with patients with symptomatic recurrences.CONCLUSIONS In this cohort, 42% of the recurrences after initial curative treatment for colon cancer were found during non-scheduled interval visits, mainly based on symptoms. Primary care physicians who take care of patients whose colon cancer might recur should be aware of the relatively high rate of symptomatic recurrences and of typical presenting symptoms.