Follow-up strategies for patients treated for non-metastatic colorectal cancer

Jeffery, Mark; Hickey, Brigid E; Hider, Phil

doi:10.1002/14651858.cd002200.pub4

Cited by 83 publications

(107 citation statements)

References 119 publications

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“…With an estimated 250,000 people in the UK having a diagnosis of CRC, pressure is evident on follow-up services through competing demands of new patient management, alongside growing numbers of survivors [2]. Traditionally, following treatment, patients enter routine outpatient follow-up (OPFU) delivered by medical clinicians, and more recently by clinical nurse specialists (CNS) [3–6], for surveillance to detect treatable recurrence and manage on-going symptoms [7, 8]. Although intensive follow-up investigations to detect recurrence after curative resection offer a survival benefit for CRC, clinical examination has been shown to be of limited value [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months

Batehup

Porter

Gage

et al. 2017

Support Care Cancer

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PurposeTo compare patient-triggered follow-up (PTFU) for curatively treated colorectal cancer against traditional outpatient follow-up (OPFU). MethodsQuestionnaires were mailed at four time points over one-year post-treatment to two prospectively-recruited cohorts: A, patients entering follow-up and receiving OPFU pre-implementation of PTFU; B, patients entering follow-up (FU) and receiving either OPFU (B1) or PTFU (B2) post-implementation of PTFU. Bi-variate tests were used to compare patient characteristics and outcomes eight months after entering follow-up (generic and cancer-specific quality of life (QoL), satisfaction). Regression analysis explored associations between follow-up model and outcomes. Resource implications and costs of models were compared.ResultsPatients in Cohort B1 were significantly more likely to have received chemotherapy (p < 0.001), radiotherapy (p < 0.05), and reported poorer QoL (p = 0.001). Having a longstanding co-morbid condition was the most important determinant of QoL (p < 0.001); model of care was not significant. Patients were satisfied with their follow-up care regardless of model. Health service costs were higher in PTFU over the first yearConclusionsPTFU is acceptable to patients with colorectal cancer and can be considered to be a realistic alternative to OPFU for clinically suitable patients. The initial costs are higher due to provision of a self-management (SM) programme and remote surveillance. Further research is needed to establish long-term outcomes and costs.Electronic supplementary materialThe online version of this article (doi:10.1007/s00520-017-3595-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months

Batehup

Porter

Gage

et al. 2017

Support Care Cancer

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“…Advances in systemic therapy and surgical options have led to an improved prognosis for many patients diagnosed with cancer and, thus, a growing population of cancer survivors . Current models of postoperative cancer surveillance among survivors may, however, be expensive, ineffective, and therefore not sustainable . In addition, the volume of surveillance visits may be a burden on the health care system, as well as providers, survivors, and family members .…”

Section: Introductionmentioning

confidence: 99%

“…Providing optimal, tailored PCC should include assessment of patient‐specific wishes related to both decisions about the surgical procedure itself, as well as how surveillance is performed in the years following operative intervention. In fact, patients can experience cancer‐specific anxiety related to undergoing active surveillance . In turn, cancer‐related anxiety can be associated with depression, mental health issues, and adversely impact patient quality‐of‐life .…”

Section: Introductionmentioning

confidence: 99%

“…In fact, patients can experience cancer‐specific anxiety related to undergoing active surveillance . In turn, cancer‐related anxiety can be associated with depression, mental health issues, and adversely impact patient quality‐of‐life . As such, data to understand patient perception, as well as preferences, related to postsurgical cancer treatment including postoperative surveillance and follow‐up, may be important.…”

Section: Introductionmentioning

confidence: 99%

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Identifying subgroups of well‐being among patients with cancer: Differences in attitudes and preferences around surveillance after curative‐intent surgery

Kelly

Hyer

Onuma

et al. 2019

Journal of Surgical Oncology

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Background Patient perceptions and preferences related to postoperative surveillance are not yet well defined. Methods A cross‐sectional analysis of the surveillance practice preferences and attitudes was undertaken based on subgroups derived from clustering participants for measures of well‐being, including financial toxicity, emotional, family/social, and functional well‐being. Results Among 212 participants, the average age was 58.1 years and most patients were female (57.1%) and white (90.2%). Common malignancies included melanoma/sarcoma (26.4%), thyroid (25.5%), breast (18.9%), gastrointestinal (18.4%), and lung (7.5%) cancer. Respondents within the highest well‐being subgroup rated their perception of communication as being the highest more consistently compared with the other well‐being subgroups (P = .005). Participants with the highest level of well‐being felt more reassured by follow‐up appointments (Subgroup 1, Med = 4.00, interquartile range (IQR) = 0.25 vs subgroup 4, Med = 3.75, IQR = 0.73, P = .023). In contrast, patients with the lowest sense of well‐being had the highest level of nervousness related to surveillance (subgroup 1, Med = 1.60, IQR = 1.00 vs subgroup 4, Med = 2.20, IQR = 1.15, P < .001). There were no differences in surveillance frequency preferences among different well‐being subgroups. Conclusion Attitudes towards postoperative surveillance varied with regard to perception of provider communication, nervous anticipation, and assuredness depending on overall patient well‐being. Providers should attempt to assess patient well‐being as part of a tailored approach to postcancer surgery surveillance.

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“…Recommendations from a variety of surgical, medical specialty, and cancer organizations including the National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology outline the type and sequence of clinical follow‐up after curative‐intent cancer treatment. While there is ongoing debate regarding optimal surveillance schedules for specific disease sites, data suggest that adherence to surveillance may portend a survival benefit and enable detection and successful treatment of asymptomatic recurrence …”

Section: Introductionmentioning

confidence: 99%

Deficiencies in postoperative surveillance for veterans with gastrointestinal cancer

Taylor

Maloney

et al. 2018

Journal of Surgical Oncology

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Background and Objectives National guidelines for gastrointestinal (GI) cancers offer surveillance algorithms to facilitate detection of recurrent disease, yet adherence rates are unknown. We sought to characterize postoperative surveillance patterns for veterans with GI cancer at a tertiary care Veterans Affairs Hospital. Methods A single‐center retrospective cohort study identified patients who underwent surgical resection for colorectal, gastroesophageal or hepatopancreaticobiliary malignancy from 2010‐2016. We calculated the annual rate of cancer‐directed clinic visits and abdominal imaging and used National Comprehensive Cancer Network guidelines as a benchmark by which to assess adequate surveillance. Results Ninety‐seven patients met inclusion criteria. Median surveillance time was 1203 days. Overall, 44% of patients had insufficient surveillance. Specifically, 11% received no postoperative imaging and 7% had no cancer‐directed clinic visits. An additional 30% received less than recommended surveillance imaging and 12% attended fewer than recommended clinic visits. By disease site, insufficient imaging was most common for patients with hepatopancreaticobiliary cancer (63%), while inadequate clinic follow‐up was highest for colorectal cancer (24%). Conclusion A significant proportion of veterans with GI cancer received either inadequate postoperative surveillance based on national guidelines. This deficiency represents an opportunity for improvement through targeted efforts, including telemedicine and education of patients and providers.

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Follow-up strategies for patients treated for non-metastatic colorectal cancer

Cited by 83 publications

References 119 publications

Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months

Follow-up after curative treatment for colorectal cancer: longitudinal evaluation of patient initiated follow-up in the first 12 months

Identifying subgroups of well‐being among patients with cancer: Differences in attitudes and preferences around surveillance after curative‐intent surgery

Deficiencies in postoperative surveillance for veterans with gastrointestinal cancer

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