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Follow-up after colorectal cancer: current practice in The Netherlands
D J Bruinvels1, A M Stiggelbout, M P Klaassen
1Medical Decision Making Unit, University Hospital Leiden, Netherlands.
The European Journal of Surgery = Acta Chirurgica
|November 1, 1995
Summary
Surgeons lack consensus on colorectal cancer follow-up care, with significant variations in recurrence detection and metastasis screening practices. Further research is needed to establish optimal follow-up strategies for improved patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Clinical Practice Research
Background:
- Postoperative follow-up is crucial for detecting colorectal cancer recurrence and metastases.
- Current follow-up practices vary significantly, potentially impacting patient outcomes.
- International comparisons highlight the need for standardized follow-up protocols.
Purpose of the Study:
- To evaluate current colorectal cancer (CRC) follow-up practices in the Netherlands.
- To compare Dutch CRC follow-up strategies with those in other countries.
- To assess surgeon attitudes towards recurrence detection and treatment.
Main Methods:
- A postal survey was conducted among all surgical departments in the Netherlands.
- A high response rate of 98% (136 out of 139 questionnaires) was achieved.
- The survey focused on attitudes towards detection and treatment of recurrences.
Main Results:
- 90% of hospitals utilize history, physical examination, and colonoscopy for local recurrence and metachronous tumors.
- Significant variation exists in attitudes towards screening for hepatic/pulmonary metastases and regional recurrence.
- These findings mirror variations observed in seven international surveys.
Conclusions:
- There is a notable lack of consensus among surgeons regarding colorectal cancer follow-up.
- Randomized controlled trials are essential to compare different follow-up strategies.
- Cost-effectiveness analyses are needed to identify patient groups benefiting most from follow-up.