[Does tumor aftercare in colorectal carcinoma make sense?]

The aim of regular follow-up of cancer patients after curative surgery is to detect any recurrence or second cancer as early as possible. Some workers have claimed that in such cases prompt surgical therapy can cure large numbers of patients. To answer this question, a detailed follow-up programme was carried out in 1054 patients (585 men, 469 women, mean age 62 [25-79] years) who had undergone surgery for colorectal cancers in TNM stages I, II, or III, the operations having been aimed at cure, not merely palliation. During a median observation time of 38 (4-140) months recurrences arose in 350 patients, while 16 patients developed a second carcinoma and 23 patients a carcinoma of some other organ. In 75 of the 350 patients there was an isolated local or regional recurrence, but in 275 patients there were distant metastases. Second operations aimed at cure were performed in 56 of the 350 patients. Only 21 of these 56 patients, i.e., 6% of all the patients whose tumours recurred, were free from cancer at the end of the observation period. The effort and expense required for a cancer follow-up programme of the kind at present advocated for patients with colorectal cancer are out of proportion to the results achieved. This conclusion should prompt a review of the value of other follow-up programmes.