Symptomatic and asymptomatic colon cancer recurrence: A multicenter cohort study

Laura A.M. Duineveld*, Kristel M. van Asselt, Willem A. Bemelman, Anke B. Smits, Pieter J. Tanis, Henk C.P.M. van Weert, Jan Wind

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

76 Citations (Scopus)

Abstract

PURPOSE:

Follow-up after colorectal cancer treatment with curative intent aims to detect recurrences and metachronous tumors in a timely manner. The objective of this study is to assess how recurrent disease presents and is diagnosed within scheduled follow-up according to the national guideline for the Netherlands. 

METHODS: 

In a retrospective study of consecutive patients with colorectal cancer who were treated in 2 hospitals in the Netherlands, we identified patients with colon cancer who underwent surgery with curative intent between January 2007 and December 2012. Patients who developed recurrent disease were included for further analyses. 

RESULTS: 

From a total of 446 patients who were been treated for colon carcinoma with curative intent, 74 developed recurrent disease (17%). In 43 of those patients (58%), recurrent disease was detected during a scheduled follow-up visit, with 41 (95%) being asymptomatic. Tumor marker testing, imaging, and colonoscopy identified all of these recurrences. In the remaining 31 patients with recurrent disease (42%), recurrence was found during non-scheduled interval visits; 26 (84%) of these patients were symptomatic. The most prevalent symptoms were abdominal pain, altered defecation, and weight loss. Patients with asymptomatic recurrences had a significantly higher overall survival compared with patients with symptomatic recurrences. 

CONCLUSIONS:

In this cohort, 42% of the recurrences after initial curative treatment for colon cancer were found during non-scheduled interval visits, mainly based on symptoms. Primary care physicians who take care of patients whose colon cancer might recur should be aware of the relatively high rate of symptomatic recurrences and of typical presenting symptoms.

Original languageEnglish
Pages (from-to)215-220
Number of pages6
JournalAnnals of Family Medicine
Volume14
Issue number3
DOIs
Publication statusPublished - 1 May 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016, Annals of Family Medicine, Inc. All rights reserved.

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