CoChat
Sign Up
Cited by 322Colorectal Cancer Surgical TreatmentsColorectal Cancer Treatments and StudiesColorectal Cancer Screening and Detection

Follow-Up of Patients with Colorectal Cancer A Meta-Analysis

Open access
Bruinvels, David J., Stiggelbout, Anne M., Kievit, Job, van Houwellngen, Hans C., F. Habbema, J. Dik, van de Velde, Cornelis J. H.·1994·Annals of Surgery
DOI 10.1097/00000658-199402000-00009PMC PMC1243119
Open this paper in CoChat — free account

Abstract

OBJECTIVE: The authors sought to determine whether intensive follow-up improves 5-year survival rates in patients with colorectal cancer who were operated on for cure. SUMMARY BACKGROUND DATA: Intensive follow-up of patients with colorectal cancer is still controversial. The present uncertainty in regard to the value of intensive follow-up could be the result of the absence of prospective randomized studies comparing patients with and without follow-up. METHODS: Studies comparing two follow-up programs of different intensities were identified in the medical literature and were aggregated in a meta-analysis using the "random effects method." Seven nonrandomized studies describing 3283 patients were analyzed. RESULTS: Patients with intensive follow-up did have 9% better 5-year survival rates than did those with minimal or no follow-up, only when intensive follow-up included carcinoembryonic antigen (CEA) assays. In addition, more asymptomatic recurrences were detected and more recurrences were resected in patients with intensive follow-up. CONCLUSIONS: This meta-analysis indicated that intensive follow-up using CEA assays can identify treatable recurrences at a relatively early stage. Treatment of these recurrences appears to be associated with improved 5-year survival rates. However, not all intensive follow-up strategies will be equally effective. Follow-up may yield the best results if diagnostic tests are used only to detect those recurrences that can be operated on with curative intent and when follow-up is "individualized," according to patient characteristics.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/00000658-199402000-00009

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In reports from Europe and the United States, approximately 50% of recurrences after curative resection were detected within 1 year after surgery.

    “approximately 50% of the recurrences were detected within 1 year after surgery”

    From Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer (2018) · cites this paper as [132]

    The available Results summary reports that intensive follow-up detected more asymptomatic recurrences, but gives no proportion detected within one year of surgery. Searches for the 50% figure and first-year recurrence timing found only the summary and reference list; the decisive timing data are not available in our copy. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

  • Approximately 70% of recurrences were detected within 2 years after surgery.

    “that approximately 70% of the recurrences were detected within 2 years after surgery [132, 133]”

    From Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer (2018) · cites this paper as [132]

    The indexed Results passage reports that intensive follow-up detected more asymptomatic recurrences, but gives no proportion detected within two years of surgery. Searches for “70%” and for recurrences detected within two years found no passage establishing the claimed timing or percentage. (LLM, conf=0.72)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 36

  1. Adloff M., Arnaud J. P., Ollier J. C., Schloegel M. Peut-on améliorer le pronostic des malades opérés d'un cancer du côlon ou du rectum par une surveillance régulière? Etude prospective portant sur 909 patients. Chirurgie. 1989;115(3):228–237. [PubMed] [Google Scholar]
  2. Ballantyne G. H., Modlin I. M. Postoperative follow-up for colorectal cancer: who are we kidding? J Clin Gastroenterol. 1988 Aug;10(4):359–364. [PubMed] [Google Scholar]
  3. Beart R. W., Jr, O'Connell M. J. Postoperative follow-up of patients with carcinoma of the colon. Mayo Clin Proc. 1983 Jun;58(6):361–363. [PubMed] [Google Scholar]
  4. Berge T., Ekelund G., Mellner C., Pihl B., Wenckert A. Carcinoma of the colon and rectum in a defined population. An epidemiological, clinical and postmortem investigation of colorectal carcinoma and coexisting benign polyps in Malmö, Sweden. Acta Chir Scand Suppl. 1973;438:1–86. [PubMed] [Google Scholar]
  5. Boring C. C., Squires T. S., Tong T. Cancer statistics, 1992. CA Cancer J Clin. 1992 Jan-Feb;42(1):19–38. doi: 10.3322/canjclin.42.1.19. [DOI] [PubMed] [Google Scholar] · DOI
  6. Brunner H. Nachsorge beim kolorektalen Karzinom. Wien Med Wochenschr. 1988 Jun 30;138(11-12):261–263. [PubMed] [Google Scholar]
  7. Bülow S., Svendsen L. B., Mellemgaard A. Metachronous colorectal carcinoma. Br J Surg. 1990 May;77(5):502–505. doi: 10.1002/bjs.1800770509. [DOI] [PubMed] [Google Scholar] · DOI
  8. Cochrane J. P., Williams J. T., Faber R. G., Slack W. W. Value of outpatient follow-up after curative surgery for carcinoma of the large bowel. Br Med J. 1980 Mar 1;280(6214):593–595. doi: 10.1136/bmj.280.6214.593. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
  9. DerSimonian R., Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
  10. Deveney K. E., Way L. W. Follow-up of patients with colorectal cancer. Am J Surg. 1984 Dec;148(6):717–722. doi: 10.1016/0002-9610(84)90423-9. [DOI] [PubMed] [Google Scholar] · DOI
  11. Devesa J. M., Morales V., Enriquez J. M., Nuño J., Camuñas J., Hernandez M. J., Avila C. Colorectal cancer. The bases for a comprehensive follow-up. Dis Colon Rectum. 1988 Aug;31(8):636–652. doi: 10.1007/BF02556803. [DOI] [PubMed] [Google Scholar] · DOI
  12. Ekman C. A., Gustavson J., Henning A. Value of a follow-up study of recurrent carcinoma of the colon and rectum. Surg Gynecol Obstet. 1977 Dec;145(6):895–897. [PubMed] [Google Scholar]
  13. Enker W. E., Kramer R. G. The follow-up of patients after definitive resections for large bowel cancer. World J Surg. 1982 Sep;6(5):578–584. doi: 10.1007/BF01657872. [DOI] [PubMed] [Google Scholar] · DOI
  14. Fucini C., Rosi S., Herd-Smith A., Malatantis G., Panichi S. Significato e limiti del follow up intensivo dopo intervento radicale per cancro del colon-retto. Minerva Chir. 1985 Jun 15;40(11):783–786. [PubMed] [Google Scholar]
  15. Guttormsen A. B., Holm J. C., Horn A., Søreide O. Follow-up of patients with large bowel cancer: a critical evaluation. Acta Chir Scand. 1984;150(4):325–330. [PubMed] [Google Scholar]
  16. Isbister W. H. The follow-up of patients following surgery for colorectal cancer--a personal view. Ann Acad Med Singapore. 1988 Jan;17(1):66–71. [PubMed] [Google Scholar]
  17. Kievit J., van de Velde C. J. Utility and cost of carcinoembryonic antigen monitoring in colon cancer follow-up evaluation. A Markov analysis. Cancer. 1990 Jun 1;65(11):2580–2587. doi: 10.1002/1097-0142(19900601)65:11<2580::aid-cncr2820651131>3.0.co;2-i. [DOI] [PubMed] [Google Scholar] · DOI
  18. Kronborg O., Fenger C., Deichgräber E., Hansen L. Follow-up after radical surgery for colorectal cancer. Design of a randomized study. Scand J Gastroenterol Suppl. 1988;149:159–162. doi: 10.3109/00365528809096975. [DOI] [PubMed] [Google Scholar] · DOI
  19. Langevin J. M., Wong W. D. What is appropriate follow-up for the patient with colorectal cancer? Can J Surg. 1985 Sep;28(5):424–428. [PubMed] [Google Scholar]
  20. Mann C. Meta-analysis in the breech. Science. 1990 Aug 3;249(4968):476–480. doi: 10.1126/science.2382129. [DOI] [PubMed] [Google Scholar] · DOI
  21. Mentges B. Kontroversen in der Nachsorge des Kolonkarzinoms. Zentralbl Chir. 1988;113(17):1087–1092. [PubMed] [Google Scholar]
  22. Mentges B., Stahlschmidt M., Brückner R. Die Effektivität der Nachsorge beim Coloncarcinom. Langenbecks Arch Chir. 1987;370(4):223–234. doi: 10.1007/BF01259310. [DOI] [PubMed] [Google Scholar] · DOI
  23. Metzger U., Bronz K., Bühler H., Dolder A., Seefeld U., Hollinger A., Largiadèr F. Die prospektive Nachsorgestudie radikal operierter kolorektaler Karzinome. Stand nach 5 Jahren. Schweiz Med Wochenschr. 1985 Jul 20;115(29):1001–1004. [PubMed] [Google Scholar]
  24. Ovaska J. T., Järvinen H. J., Mecklin J. P. The value of a follow-up programme after radical surgery for colorectal carcinoma. Scand J Gastroenterol. 1989 May;24(4):416–422. doi: 10.3109/00365528909093068. [DOI] [PubMed] [Google Scholar] · DOI
  25. Ovaska J., Järvinen H., Kujari H., Perttilä I., Mecklin J. P. Follow-up of patients operated on for colorectal carcinoma. Am J Surg. 1990 Jun;159(6):593–596. doi: 10.1016/s0002-9610(06)80074-7. [DOI] [PubMed] [Google Scholar] · DOI
  26. Polk H. C., Jr, Spratt J. S., Jr Recurrent colorectal carcinoma: detection, treatment, and other considerations. Surgery. 1971 Jan;69(1):9–23. [PubMed] [Google Scholar]
  27. Pugliese V., Aste H., Saccomanno S., Bruzzi P., Bonelli L., Santi L. Outcome of follow-up programs in patients previously resected for colorectal cancer. Tumori. 1984 Apr 30;70(2):203–208. doi: 10.1177/030089168407000216. [DOI] [PubMed] [Google Scholar] · DOI
  28. Püschmann H., Anders A., Winter J., Dorn B. Rationale computergestützte Nachsorge bei kolorektalen Tumoren. Kritische Anmerkingen zu einer Nachsorgesprechstunde. Med Welt. 1981 Apr 10;32(15):567–571. [PubMed] [Google Scholar]
  29. Rampf W., Bittner R., Wiborg A., Beger H. G. Früherkennung und Heilungschanchen bei Rezidiven colorectaler Carcinome. Langenbecks Arch Chir. 1985;366:480–485. doi: 10.1007/BF01836691. [DOI] [PubMed] [Google Scholar] · DOI
  30. Rocklin M. S., Slomski C. A., Watne A. L. Postoperative surveillance of patients with carcinoma of the colon and rectum. Am Surg. 1990 Jan;56(1):22–27. [PubMed] [Google Scholar]
  31. Secco G. B., Fardelli R., Campora E., Rovida S., Ratto G. B., Motta G. Postoperative surveillance of colorectal cancer according to risk category. Ital J Surg Sci. 1989;19(3):239–245. [PubMed] [Google Scholar]
  32. Steele G., Jr Follow-up plans after treatment of primary colon and rectum cancer. World J Surg. 1991 Sep-Oct;15(5):583–588. doi: 10.1007/BF01789202. [DOI] [PubMed] [Google Scholar] · DOI
  33. Sugarbaker P. H., Gianola F. J., Dwyer A., Neuman N. R. A simplified plan for follow-up of patients with colon and rectal cancer supported by prospective studies of laboratory and radiologic test results. Surgery. 1987 Jul;102(1):79–87. [PubMed] [Google Scholar]
  34. Törnqvist A., Ekelund G., Leandoer L. The value of intensive follow-up after curative resection for colorectal carcinoma. Br J Surg. 1982 Dec;69(12):725–728. doi: 10.1002/bjs.1800691213. [DOI] [PubMed] [Google Scholar] · DOI
  35. Wachter K. W. Disturbed by meta-analysis? Science. 1988 Sep 16;241(4872):1407–1408. doi: 10.1126/science.3420397. [DOI] [PubMed] [Google Scholar] · DOI
  36. Wenzl E., Wunderlich M., Herbst F., Schemper M., Feil W., Rauhs R., Schiessel R. Results of a rigorous follow-up system in colorectal cancer. Int J Colorectal Dis. 1988 Aug;3(3):176–180. doi: 10.1007/BF01648363. [DOI] [PubMed] [Google Scholar] · DOI

Cited by

Sorted by citations

Authors
Bruinvels, D. J., Stiggelbout, A. M., Kievit, J., van Houwellngen, H. C., F. Habbema, J. D., & van de Velde, C. J. H.
Affiliations
  • Leiden University (NL)
  • Erasmus University Rotterdam (NL)
Corresponding author
  • Bruinvels, David J.
  • Stiggelbout, Anne M.
  • Kievit, Job
ORCID
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1994-02
Volume
219
Issue
2
Pages
174-182
ISSN
0003-4932 (ISSN-L)
DOI
10.1097/00000658-199402000-00009
PMC
PMC1243119
OpenAlex
W1975608200
Cited by
322
References
1
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 3 · 2019: 6 · 2018: 3 · 2017: 8 · 2016: 4 · 2015: 10 · 2014: 7 · 2013: 14 · 2012: 12
FWCI
4.82
Type
journal article
Language
en
Open access
Locations
  • Annals of Surgery (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
Keywords
colorectal cancer, postoperative follow-up, intensive follow-up, carcinoembryonic antigen, five-year survival, recurrence detection, curative resection, personalized follow-up
MeSH terms
Actuarial Analysis, Follow-Up Studies, Humans, Neoplasm Recurrence, Local, Colorectal Neoplasms, Survival Rate

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review