| Theme |
The surveillance program after treatment of colorectal cancers |
| Title |
Surveillance after surgery for colo-rectal carcinomas |
| Author |
Haruhiko Okamoto |
Division of Surgical Oncology, Department of Molecular Genetics, Niigata University |
| Author |
Tatsuo Tani |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Tsuneo Iiai |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Tomoaki Maruta |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Masaaki Shimoyama |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Satoshi Maruyama |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Tomonori Miyazawa |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Hitoshi Nogami |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Hiroki Shimizu |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Katsuyoshi Hatakeyama |
Division of Digestive and General Surgery, Department of Surgery, Niigata University |
| Author |
Toshiyuki Yamazaki |
Department of Surgery, Niigata Citizen's Hospital |
| [ Summary ] |
We investigated the metastasis or recurrence of colo-rectal carcinoma after curative surgery. In 144 patients, 41 patients developed a recurrence or metastasis. Lung metastasis usually occured a long time after surgery, so follow ups should be done over a long period. For liver metastasis, long follow ups are also important but early detection is important too. Additional operations for lung and liver metastasis are valuable. Our results revealed a 30-40% 5-year survival rate. Local recurrence and lymph node recurrence usually occured within two years after surgery. Results of additional operations for local recurrence are not as good but some reports have shown good 5-year survival rates (over 30%). We think recurrences should be found early and additional operations are recommended.
Concerning colonoscopic surveillance after curative surgery for colo-rectal carcinoma, 284 patients were followed up on endoscopically. The risk factor for developing metachronous carcinoma is related to the presence of synchronous adenoma or carcinoma at the time of the initial operation. To detect metachronous carcinomas at a curable stage, annual colonoscopic surveillance should be performed on high risk patients. For low risk patients, annual colonoscopic surveillance should be performed 2-3 years after surgery, then intervals of the examination may become longer and finally colonoscopic examination may be done only when the patient has a positive fecal occult blood test. |