Follow-up of patients with large bowel cancer: a critical evaluation

A study of 102 consecutive patients hospitalized for large bowel cancer in the period 1975-1976 was performed to evaluate the hospital's follow-up programme in such cases. The overall five-year survival rate was 32%. New pathologic changes (previously unknown malignant or benign tumour) were found in 42% of the patients. The incidence of new pathology was highest among patients with tumours of Dukes' category C, followed by Dukes' B and A, respectively. The probability of new pathology detection was high in the first two years after primary operation for colonic cancer and thereafter the risk seemed to be small. This phenomenon appeared to be general, irrespective of Duke's stage and whether or not curative resection had been performed. Consumption of hospital resources did not seem to prolong patient survival, most resources being used for patients with short survival. More emphasis should be placed on detection of operable metastatic disease, or curable synchronous and metachronous pathology within the first two years after curative resection for large bowel cancer.