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Does Intensity of Surveillance Affect Outcomes in Patients With Colorectal Cancer?

By: Joseph Fanelli
Posted: Thursday, July 5, 2018

According to a study published in JAMA Oncology, no association exists between the intensity of surveillance after treatment and the detection of recurrence or overall survival in patients with stages I, II, and III colorectal cancer. The findings differ from previous studies suggesting that intensive surveillance is associated with earlier recurrence detention, commented George J. Chang, MD, MS, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues.

“As we learn more about the biology and heterogeneity of colorectal cancer, the answer is not always another test,” said Dr. Chang, in an institutional press release. “The data argue that in many cases, a less-intensive surveillance may be a better approach for patients.”

In the retrospective cohort study, the investigators assessed data from 8,529 adult patients diagnosed with stage I (25%), II (35.2%), and III (39.8%) colorectal cancer; they were treated at a Commission on Cancer–accredited facility. The patients at high-intensity facilities received an average of 2.9 imaging scans and 4.3 carcinoembryonic antigen (CEA) tests, with patients at low-intensity centers averaging 1.6 imaging scans and 1.6 CEA tests.

In the high-intensity cohort, the median time to detection of recurrence was 15.1 months with imaging surveillance and 15.9 months with CEA testing; for the low-intensity cohort, the median time to detection of recurrence was 16.0 months with imaging surveillance and 15.3 months with CEA testing. Also, between imaging and CEA testing, the authors found no significant difference in the rates of resection (hazard ratio = 1.22 and 1.12, respectively) or overall survival (hazard ratio = 1.01 and 0.96, respectively).


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