Routine colonoscopy in the management of colorectal carcinoma

Weber, Carlos A.; Deveney, Karen E.; Pellegrinl, Carlos A.; Way, Lawrence W.

doi:10.1016/0002-9610(86)90150-9

Cited by 34 publications

(15 citation statements)

References 14 publications

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“…Neither individual randomized controlled trials of intensive surveillance with colonoscopy 20 nor meta‐analyses of these trials 26 have demonstrated a survival benefit from the original primary tumor by performing colonoscopy at annual or shorter intervals. The failure of surveillance endoscopic exams to improve survival from recurrent colorectal cancer appears to result from relatively low rates of anastomotic or intraluminal recurrence and the observation that anastomotic or intraluminal recurrences are generally associated with intraabdominal or pelvic disease that is unresectable for cure 2–24,26,27 , , , , , , , , , , , , , , , , , , , , , , , , . In summary, performance of annual colonoscopy for the purpose of detecting recurrent disease does not have an established survival benefit for patients with colorectal cancer.…”

Section: Discussion Of Evidence and Rationale For The Recommendationsmentioning

confidence: 99%

“…A total of 66 studies were retrieved for detailed evaluation, and 43 were excluded: 26 because of incomplete perioperative colonoscopic clearing or because this was accomplished with modalities other than colonoscopy, 13 did not pertain to the focus of our paper, three were reports of work in progress that were published in final form in other studies included in our analysis, and one reported the preliminary results of an ongoing trial. The remaining 23 studies were included in our analysis 2–24 , , , , , , , , , , , , , , , , , , , , , , …”

Section: Methodology and Literature Searchmentioning

confidence: 99%

See 1 more Smart Citation

Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer

Rex

Kahi

Levin

et al. 2006

CA: A Cancer Journal for Clinicians

174

183

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Patients with resected colorectal cancer are at risk for recurrent cancer and metachronous neoplasms in the colon. This joint update of guidelines by the American Cancer Society (ACS) and US Multi-Society Task Force on Colorectal Cancer addresses only the use of endoscopy in the surveillance of these patients. Patients with endoscopically resected Stage I colorectal cancer, surgically resected Stage II and III cancers, and Stage IV cancer resected for cure (isolated hepatic or pulmonary metastasis) are candidates for endoscopic surveillance. The colorectum should be carefully cleared of synchronous neoplasia in the perioperative period. In nonobstructed colons, colonoscopy should be performed preoperatively. In obstructed colons, double contrast barium enema or computed tomography colonography should be done preoperatively, and colonoscopy should be performed 3 to 6 months after surgery. These steps complete the process of clearing synchronous disease. After clearing for synchronous disease, another colonoscopy should be performed in 1 year to look for metachronous lesions. This recommendation is based on reports of a high incidence of apparently metachronous second cancers in the first 2 years after resection. If the examination at 1 year is normal, then the interval before the next subsequent examination should be 3 years. If that colonoscopy is normal, then the interval before the next subsequent examination should be 5 years. Shorter intervals may be indicated by associated adenoma findings (see Postpolypectomy Surveillance Guideline). Shorter intervals are also indicated if the patient's age, family history, or tumor testing indicate definite or probable hereditary nonpolyposis colorectal cancer. Patients undergoing low anterior resection of rectal cancer generally have higher rates of local cancer recurrence, compared with those with colon cancer. Although effectiveness is not proven, performance of endoscopic ultrasound or flexible sigmoidoscopy at 3-to 6-month intervals for the first 2 years after resection can be considered for the purpose of detecting a surgically curable recurrence of the original rectal cancer. (CA Cancer J Clin 2006;56:160-167.)

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Section: Discussion Of Evidence and Rationale For The Recommendationsmentioning

confidence: 99%

Section: Methodology and Literature Searchmentioning

confidence: 99%

Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer

Rex

Kahi

Levin

et al. 2006

CA: A Cancer Journal for Clinicians

174

183

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“…The present yield of 25% in patients undergoing adenoma follow up is consistent with a mean yield of 30% from several studies reviewed recently [ 5]. In patients undergoing cancer follow up, the present yield of 17% appears low in comparison with a mean yield of 25% reported by Rex [ 5], but is consistent with other studies [ 6, 7]. A lower prevalence of adenomas in patients undergoing cancer follow up than in those undergoing adenoma follow up has been reported previously [ 8], but the underlying reasons are unclear.…”

Section: Discussionmentioning

confidence: 99%

Prediction of colonoscopic yield of neoplasia

et al. 1999

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“…Four metachronous colon cancers were found and were resected for cure. Weber and Deveney [19] and Kronborg et al [20] have also found that an extremely low incidence of anastomotic recurrences (0-2.1%) are discovered with annual colonoscopy. Juhl et al [18] concluded that colonoscopy is more useful for the detection and cure of early metachronous lesions than the detection and cure of recurrent disease.…”

Section: Park Roadmentioning

confidence: 98%

Follow‐up of patients after primary colorectal cancer resection

Pommier

Woltering

1991

Seminars in Surgical Oncology

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Improved survival rates for patients with colorectal cancer may depend on early detection of metachronous colon lesions and early detection of distant disease. Frequent serial CEA determinations and history and physical examination are the two most useful techniques for diagnosing early recurrent disease. Colonoscopy rarely detects early recurrent disease but is useful in finding metachronous colon lesions. Other radiographic and hematologic examinations have an extremely low yield and should be used to localize and stage disease discovered by other means. Simplified follow-up can be expected to minimize early detection of recurrent and metachronous lesions yet offers minimal patient risk and expense.

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Routine colonoscopy in the management of colorectal carcinoma

Cited by 34 publications

References 14 publications

Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer

Guidelines for Colonoscopy Surveillance after Cancer Resection: A Consensus Update by the American Cancer Society and US Multi-Society Task Force on Colorectal Cancer

Prediction of colonoscopic yield of neoplasia

Follow‐up of patients after primary colorectal cancer resection

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