[Colorectal cancer: follow-up after curative resection]

From Jan 1978 to Dec 1984, 128 patients had a curative resection of colorectal carcinoma. A program for early detection and surgical correction of recurrences was initiated in 88 patients with a mean age of 61 years (range 24 to 85). Seventy two patients complied with the program involving clinical examination, chest X-ray, alkaline phosphatase and CEA determinations and endoscopy at 6 month intervals. Mean follow up was 36 months (range 6 to 60). A total of 28 recurrences (32%) were detected: 4 local, 17 distant and 7 local and distant. Recurrences occurred in 46% of grade C, 19% of grade B and 0% of grade A lesions. Sixty eight% of recurrences were detected within 12 months and 93% within 36 months after surgery. Recurrences were detected by clinical examination in 71% of cases. CEA determination was sensitive (81% and specific (92%) for detection of recurrences in the remaining patients. Four patients (14%) were reoperated on with a survival of 3 to 26 months, all dying from disseminated disease. We conclude that this program did not help to improve the 5 year survival rate of colorectal carcinoma submitted to curative resection. CEA determination may be indicated at 2 month intervals during the period of increased recurrence risk.