Surveillance strategies following curative resection and nonoperative approach of rectal cancer:How and how long?Review of current recommendations  

作　　者：Andrea Lauretta Giulia Montori Gian Piero Guerrini 

机构地区：[1]Department of Surgical Oncology,Centro di Riferimento Oncologico di Aviano IRCCS,Aviano 33081,Italy [2]Department of General Surgery,Vittorio Veneto Hospital,ULSS 2 Marca Trevigiana,Vittorio Veneto 31029,Italy [3]Hepato-Pancreato-Biliary Surgical Oncology and Liver Transplantation Unit,Policlinico-AUO Modena,Modena 41124,Italy

出　　处：《World Journal of Gastrointestinal Surgery》2023年第2期177-192,共16页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Different follow-up strategies are available for patients with rectal cancer following curative treatment.A combination of biochemical testing and imaging investigation,associated with physical examination are commonly used.However,there is currently no consensus about the types of tests to perform,the timing of the testing,and even the need for follow-up at all has been questioned.The aim of this study was to review the evidence of the impact of different followup tests and programs in patients with non-metastatic disease after definitive treatment of the primary.A literature review was performed of studies published on MEDLINE,EMBASE,the Cochrane Library and Web of Science up to November 2022.Current published guidelines from the most authoritative specialty societies were also reviewed.According to the follow-up strategies available,the office visit is not efficient but represents the only way to maintain direct contact with the patient and is recommended by all authoritative specialty societies.In colorectal cancer surveillance,carcinoembryonic antigen represents the only established tumor marker.Abdominal and chest computed tomography scan is recommended considering that the liver and lungs are the most common sites of recurrence.Since local relapse in rectal cancer is higher than in colon cancer,endoscopic surveillance is mandatory.Different follow-up regimens have been published but randomized comparisons and meta-analyses do not allow to determine whether intensive or less intensive follow-up had any significant influence on survival and recurrence detection rate.The available data do not allow the drawing of final conclusions on the ideal surveillance methods and the frequency with which they should be applied.It is very useful and urgent for clinicians to identify a cost-effective strategy that allows early identification of recurrence with a special focus for highrisk patients and patients undergoing a“watch and wait”approach.

关 键 词：Rectal cancer FOLLOW-UP SURVEILLANCE RECURRENCE Carcinoembryonic antigen Computed tomography 

分 类 号：R730.5[医药卫生—肿瘤]