Intensive follow-up of patients after curative surgery for colorectal cancer is common in clinical practice, but evidence of a survival benefit is limited.
Dr Peer Wille-Jørgensen and colleagues examined overall mortality, colorectal cancer–specific mortality, and colorectal cancer–specific recurrence rates among patients with stage II or III colorectal cancer who were randomized after curative surgery to 2 alternative schedules for follow-up testing with computed tomography and carcinoembryonic antigen.
The research team performed an unblinded randomized trial including 2509 patients with stage II or III colorectal cancer treated at 24 centers in Sweden, Denmark, and Uruguay from 2006 through 2010, and followed up for 5 years.
|The 5-year overall patient mortality rate in the high-frequency group was 13%|
|Journal of the American Medical Association|
Patients were randomized either to follow-up testing with computed tomography of the thorax and abdomen and serum carcinoembryonic antigen at 6, 12, 18, 24, and 36 months after surgery or at 12 and 36 months after surgery.
The team's primary outcomes were 5-year overall mortality and colorectal cancer–specific mortality rates.
The secondary outcome was the colorectal cancer–specific recurrence rate.
Both intention-to-treat and per-protocol analyses were performed.
Among 2555 patients who were randomized, 2509 were included in the intention-to-treat analysis completed the trial.
The researchers found that the 5-year overall patient mortality rate in the high-frequency group was 13% compared with 14% in the low-frequency group.
The 5-year colorectal cancer–specific mortality rate in the high-frequency group and low-frequency groups was 11%.
The team noted that the colorectal cancer–specific recurrence rate was 22% in the high-frequency group compared with 19% in the low-frequency group.
Dr Wille-Jørgensen's team comments, "Among patients with stage II or III colorectal cancer, follow-up testing with computed tomography and carcinoembryonic antigen more frequently compared with less frequently did not result in a significant rate reduction in 5-year overall mortality or colorectal cancer–specific mortality."