Publicação
Intensive Follow-Up After Curative Surgery for Colorectal Cancer
| Resumo: | Introduction: The purpose of postoperative surveillance programs after curative treatment for colorectal cancer is to detect asymptomatic recurrences with the premise that an important rate will be eligible for curative resection, improving overall survival. We have implemented a surveillance program for patients with colorectal cancer, stages II-III, with periodic clinical, carcinoembryonic antigen and cancer antigen-19-9 assessment, computed tomography and colonoscopy. The aim of this study was to assess the rate of curative treatment of recurrence, colorectal cancer mortality and clinical characteristics associated with non-resectable recurrence.Material and Methods: Open cohort study, single center. All patients on the intensive surveillance program between March 2008 and January 2015 were included. Statistics: chi-square, Wilcoxon rank sum test, logistic regression, Kaplan-Meier log-rank test (SPSS20®).Results: We had a total 404 patients evaluated; 59.6% male; mean age of 65 ± 10 years; 50.7% rectal tumor; 56.2% stage III. The average time of follow-up was 37 months and the recurrence rate was 12.9% (n = 52), mostly detected in the first three years (88.4%). The pattern of recurrence was associated with the site of the primary tumor (p < 0.001). Twenty-one patients underwent curative resection. Factors associated with non-resectable recurrence were aged ≥ 70 years (p = 0.022), disease location in the colon (p = 0.033) and cancer antigen-19-9-9 elevation (p = 0.024). The overall rate of cancer-specific mortality was 2.2% (n = 9).Discussion: The association between colon cancer and non-resectable recurrence is explained by the higher rate of disseminated disease in these patients. Cancer antigen-19-9 added no benefit to the surveillance program.Conclusion: This intensive real-world postoperative surveillance program allowed performing curative surgery to 40.3% of patients with recurrence. |
|---|---|
| Autores principais: | Rodrigues, Rita Vale |
| Outros Autores: | Silva, João Pereira da; Rosa, Isadora; Santos, Isabel; Pereira, Nuno; Soares, Carla; Pereira, António Dias |
| Assunto: | cContinuity of Patient Care Colorectal Neoplasms/surgery Follow-Up Studies Survival Analysis Análise de Sobrevida Continuidade de Cuidados ao Doente Neoplasias Colorrectais/cirurgia Seguimento |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | unknown |
| Instituição associada: | Ordem dos Médicos |
| Idioma: | inglês |
| Origem: | Acta Médica Portuguesa |
| _version_ | 1867503006139809792 |
|---|---|
| author | Rodrigues, Rita Vale |
| author2 | Silva, João Pereira da Rosa, Isadora Santos, Isabel Pereira, Nuno Soares, Carla Pereira, António Dias |
| author2_role | author author author author author author |
| author_facet | Rodrigues, Rita Vale Silva, João Pereira da Rosa, Isadora Santos, Isabel Pereira, Nuno Soares, Carla Pereira, António Dias |
| author_role | author |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Rodrigues, Rita Vale\"},{\"Person.name\":\"Silva, João Pereira da\"},{\"Person.name\":\"Rosa, Isadora\"},{\"Person.name\":\"Santos, Isabel\"},{\"Person.name\":\"Pereira, Nuno\"},{\"Person.name\":\"Soares, Carla\"},{\"Person.name\":\"Pereira, António Dias\"}] |
| datacite.creators.creator.creatorName.fl_str_mv | Rodrigues, Rita Vale Silva, João Pereira da Rosa, Isadora Santos, Isabel Pereira, Nuno Soares, Carla Pereira, António Dias |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | cContinuity of Patient Care Colorectal Neoplasms/surgery Follow-Up Studies Survival Analysis Análise de Sobrevida Continuidade de Cuidados ao Doente Neoplasias Colorrectais/cirurgia Seguimento |
| datacite.titles.title.fl_str_mv | Intensive Follow-Up After Curative Surgery for Colorectal Cancer Vigilância Intensiva do Carcinoma Colo-Rectal após Tratamento de Intenção Curativa |
| dc.creator.none.fl_str_mv | Rodrigues, Rita Vale Silva, João Pereira da Rosa, Isadora Santos, Isabel Pereira, Nuno Soares, Carla Pereira, António Dias |
| dc.description.none.fl_str_mv | Introdução: A vigilância intensiva pós-operatória do carcinoma colo-retal permite a deteção da recorrência em fase assintomática, aumentando o número de doentes que podem beneficiar de nova cirurgia. Implementámos um programa de vigilância de doentes com carcinoma colo-retal estádios II-III, operados com intenção curativa, com avaliação clínica, tomografia computorizada e colonoscopia. O presente estudo teve como objectivos avaliar a taxa de cirurgia de intenção curativa, a taxa de mortalidade por cancro e identificar características clínicas associadas à irresecabilidade da recidiva.Material e Métodos: Estudo de coorte, unicêntrico. Foram incluídos todos os doentes com carcinoma colo-retal integrados em programa de vigilância entre março de 2008 e janeiro de 2015. Análise estatística: qui-quadrado, Wilcoxon, regressão logística, Kaplan-Meier (SPSS20®).Resultados: Avaliámos 404 doentes; idade média: 65 ± 10 anos, 59,6% sexo masculino, 50,7% reto, 56,2% estádio III. O tempo médio de vigilância foi 37 meses e a taxa de recidiva foi 12,9% (n = 52), a maioria detetada nos primeiros três anos (88,4%). O padrão de recidiva associou-se à localização do tumor primário (p < 0,001). Vinte e um doentes foram submetidos a cirurgia curativa. Os fatores associados a recidiva irressecável foram: idade ≥ 70 anos (p = 0,022), carcinoma colo-retal localizado no cólon (p = 0,033) e elevação de antigénio carboidrato 19-9 (p = 0,024). A taxa global de mortalidade específica por cancro foi 2,2% (n = 9).Discussão: A associação entre neoplasia do cólon e recidiva irressecável deve-se à taxa mais elevada de doença disseminada nestes doentes. O antigénio carboidrato 19-9 não trouxe benefício acrescido ao programa de vigilância.Conclusão: Este estudo confirma o interesse clínico da vigilância intensiva na deteção de recidiva assintomática, permitindo alcançar cirurgia curativa em 40,3% dos doentes com recidiva. |
| dc.format.none.fl_str_mv | application/pdf image/jpeg application/msword application/msword application/pdf |
| dc.identifier.none.fl_str_mv | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Ordem dos Médicos |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.source.none.fl_str_mv | Acta Médica Portuguesa; Vol. 30 No. 9 (2017): September; 633-641 Acta Médica Portuguesa; Vol. 30 N.º 9 (2017): Setembro; 633-641 1646-0758 0870-399X |
| dc.subject.none.fl_str_mv | cContinuity of Patient Care Colorectal Neoplasms/surgery Follow-Up Studies Survival Analysis Análise de Sobrevida Continuidade de Cuidados ao Doente Neoplasias Colorrectais/cirurgia Seguimento |
| dc.title.fl_str_mv | Intensive Follow-Up After Curative Surgery for Colorectal Cancer Vigilância Intensiva do Carcinoma Colo-Rectal após Tratamento de Intenção Curativa |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Introduction: The purpose of postoperative surveillance programs after curative treatment for colorectal cancer is to detect asymptomatic recurrences with the premise that an important rate will be eligible for curative resection, improving overall survival. We have implemented a surveillance program for patients with colorectal cancer, stages II-III, with periodic clinical, carcinoembryonic antigen and cancer antigen-19-9 assessment, computed tomography and colonoscopy. The aim of this study was to assess the rate of curative treatment of recurrence, colorectal cancer mortality and clinical characteristics associated with non-resectable recurrence.Material and Methods: Open cohort study, single center. All patients on the intensive surveillance program between March 2008 and January 2015 were included. Statistics: chi-square, Wilcoxon rank sum test, logistic regression, Kaplan-Meier log-rank test (SPSS20®).Results: We had a total 404 patients evaluated; 59.6% male; mean age of 65 ± 10 years; 50.7% rectal tumor; 56.2% stage III. The average time of follow-up was 37 months and the recurrence rate was 12.9% (n = 52), mostly detected in the first three years (88.4%). The pattern of recurrence was associated with the site of the primary tumor (p < 0.001). Twenty-one patients underwent curative resection. Factors associated with non-resectable recurrence were aged ≥ 70 years (p = 0.022), disease location in the colon (p = 0.033) and cancer antigen-19-9-9 elevation (p = 0.024). The overall rate of cancer-specific mortality was 2.2% (n = 9).Discussion: The association between colon cancer and non-resectable recurrence is explained by the higher rate of disseminated disease in these patients. Cancer antigen-19-9 added no benefit to the surveillance program.Conclusion: This intensive real-world postoperative surveillance program allowed performing curative surgery to 40.3% of patients with recurrence. |
| dirty | 0 |
| eu_rights_str_mv | unknown |
| format | article |
| id | amp_869a00d7d1e2cf98c8de98cd2dd6cbdd |
| identifier.url.fl_str_mv | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889 |
| instacron_str | om |
| institution | Ordem dos Médicos |
| instname_str | Ordem dos Médicos |
| language | eng |
| network_acronym_str | amp |
| network_name_str | Acta Médica Portuguesa |
| oai_identifier_str | oai:ojs.www.actamedicaportuguesa.com:article/7889 |
| organization_str_mv | urn:organizationAcronym:om |
| person_str_mv | Rodrigues, Rita Vale Silva, João Pereira da Rosa, Isadora Santos, Isabel Pereira, Nuno Soares, Carla Pereira, António Dias |
| publishDate | 2017 |
| publisher.none.fl_str_mv | Ordem dos Médicos |
| reponame_str | Acta Médica Portuguesa |
| repository_id_str | urn:repositoryAcronym:amp |
| service_str_mv | urn:repositoryAcronym:amp |
| spelling | en-USIntensive Follow-Up After Curative Surgery for Colorectal Cancerpt-PTVigilância Intensiva do Carcinoma Colo-Rectal após Tratamento de Intenção CurativaRodrigues, Rita ValeSilva, João Pereira daRosa, IsadoraSantos, IsabelPereira, NunoSoares, CarlaPereira, António DiascContinuity of Patient CareColorectal Neoplasms/surgeryFollow-Up StudiesSurvival AnalysisAnálise de SobrevidaContinuidade de Cuidados ao DoenteNeoplasias Colorrectais/cirurgiaSeguimentoDireitos de Autor (c) 2017 Acta Médica Portuguesahttp://purl.org/coar/access_right/c_abf2https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889URLhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889URLHasVersionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889/5152URLHasVersionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889/8522URLHasVersionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889/9229URLHasVersionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889/9480URLHasVersionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889/9562URLHasVersion2017-09-29en-USIntroduction: The purpose of postoperative surveillance programs after curative treatment for colorectal cancer is to detect asymptomatic recurrences with the premise that an important rate will be eligible for curative resection, improving overall survival. We have implemented a surveillance program for patients with colorectal cancer, stages II-III, with periodic clinical, carcinoembryonic antigen and cancer antigen-19-9 assessment, computed tomography and colonoscopy. The aim of this study was to assess the rate of curative treatment of recurrence, colorectal cancer mortality and clinical characteristics associated with non-resectable recurrence.Material and Methods: Open cohort study, single center. All patients on the intensive surveillance program between March 2008 and January 2015 were included. Statistics: chi-square, Wilcoxon rank sum test, logistic regression, Kaplan-Meier log-rank test (SPSS20®).Results: We had a total 404 patients evaluated; 59.6% male; mean age of 65 ± 10 years; 50.7% rectal tumor; 56.2% stage III. The average time of follow-up was 37 months and the recurrence rate was 12.9% (n = 52), mostly detected in the first three years (88.4%). The pattern of recurrence was associated with the site of the primary tumor (p < 0.001). Twenty-one patients underwent curative resection. Factors associated with non-resectable recurrence were aged ≥ 70 years (p = 0.022), disease location in the colon (p = 0.033) and cancer antigen-19-9-9 elevation (p = 0.024). The overall rate of cancer-specific mortality was 2.2% (n = 9).Discussion: The association between colon cancer and non-resectable recurrence is explained by the higher rate of disseminated disease in these patients. Cancer antigen-19-9 added no benefit to the surveillance program.Conclusion: This intensive real-world postoperative surveillance program allowed performing curative surgery to 40.3% of patients with recurrence.pt-PTIntrodução: A vigilância intensiva pós-operatória do carcinoma colo-retal permite a deteção da recorrência em fase assintomática, aumentando o número de doentes que podem beneficiar de nova cirurgia. Implementámos um programa de vigilância de doentes com carcinoma colo-retal estádios II-III, operados com intenção curativa, com avaliação clínica, tomografia computorizada e colonoscopia. O presente estudo teve como objectivos avaliar a taxa de cirurgia de intenção curativa, a taxa de mortalidade por cancro e identificar características clínicas associadas à irresecabilidade da recidiva.Material e Métodos: Estudo de coorte, unicêntrico. Foram incluídos todos os doentes com carcinoma colo-retal integrados em programa de vigilância entre março de 2008 e janeiro de 2015. Análise estatística: qui-quadrado, Wilcoxon, regressão logística, Kaplan-Meier (SPSS20®).Resultados: Avaliámos 404 doentes; idade média: 65 ± 10 anos, 59,6% sexo masculino, 50,7% reto, 56,2% estádio III. O tempo médio de vigilância foi 37 meses e a taxa de recidiva foi 12,9% (n = 52), a maioria detetada nos primeiros três anos (88,4%). O padrão de recidiva associou-se à localização do tumor primário (p < 0,001). Vinte e um doentes foram submetidos a cirurgia curativa. Os fatores associados a recidiva irressecável foram: idade ≥ 70 anos (p = 0,022), carcinoma colo-retal localizado no cólon (p = 0,033) e elevação de antigénio carboidrato 19-9 (p = 0,024). A taxa global de mortalidade específica por cancro foi 2,2% (n = 9).Discussão: A associação entre neoplasia do cólon e recidiva irressecável deve-se à taxa mais elevada de doença disseminada nestes doentes. O antigénio carboidrato 19-9 não trouxe benefício acrescido ao programa de vigilância.Conclusão: Este estudo confirma o interesse clínico da vigilância intensiva na deteção de recidiva assintomática, permitindo alcançar cirurgia curativa em 40,3% dos doentes com recidiva.Ordem dos Médicosapplication/pdfimage/jpegapplication/mswordapplication/mswordapplication/pdfen-USActa Médica Portuguesa; Vol. 30 No. 9 (2017): September; 633-641pt-PTActa Médica Portuguesa; Vol. 30 N.º 9 (2017): Setembro; 633-6411646-07580870-399Xengjournal articlehttp://purl.org/coar/resource_type/c_6501literatureVoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85 |
| spellingShingle | Intensive Follow-Up After Curative Surgery for Colorectal Cancer Rodrigues, Rita Vale cContinuity of Patient Care Colorectal Neoplasms/surgery Follow-Up Studies Survival Analysis Análise de Sobrevida Continuidade de Cuidados ao Doente Neoplasias Colorrectais/cirurgia Seguimento |
| status | SINGLETON |
| status_str | VoR |
| subject.fl_str_mv | cContinuity of Patient Care Colorectal Neoplasms/surgery Follow-Up Studies Survival Analysis Análise de Sobrevida Continuidade de Cuidados ao Doente Neoplasias Colorrectais/cirurgia Seguimento |
| title | Intensive Follow-Up After Curative Surgery for Colorectal Cancer |
| title_full | Intensive Follow-Up After Curative Surgery for Colorectal Cancer |
| title_fullStr | Intensive Follow-Up After Curative Surgery for Colorectal Cancer |
| title_full_unstemmed | Intensive Follow-Up After Curative Surgery for Colorectal Cancer |
| title_short | Intensive Follow-Up After Curative Surgery for Colorectal Cancer |
| title_sort | Intensive Follow-Up After Curative Surgery for Colorectal Cancer |
| topic | cContinuity of Patient Care Colorectal Neoplasms/surgery Follow-Up Studies Survival Analysis Análise de Sobrevida Continuidade de Cuidados ao Doente Neoplasias Colorrectais/cirurgia Seguimento |
| topic_facet | cContinuity of Patient Care Colorectal Neoplasms/surgery Follow-Up Studies Survival Analysis Análise de Sobrevida Continuidade de Cuidados ao Doente Neoplasias Colorrectais/cirurgia Seguimento |
| url | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7889 |
| visible | 1 |