Consensus and controversies regarding follow-up after treatment with curative intent of nonmetastatic colorectal cancer: a synopsis of guidelines used in countries represented in the European Society of Coloproctology
Consensus and controversies regarding follow-up after treatment with curative intent of nonmetastatic colorectal cancer: a synopsis of guidelines used in countries represented in the European Society of Coloproctology
AIM: It is common clinical practice to follow patients for a period of years after treatment with curative intent of nonmetastatic colorectal cancer, but follow-up strategies vary widely. The aim of this systematic review was to provide an overview of recommendations on this topic in guidelines from member countries of the European Society of Coloproctology, with supporting evidence.
METHOD: A systematic search of Medline, Embase and the guideline databases Trip database, BMJ Best Practice and Guidelines International Network was performed. Quality assessment included use of the AGREE-II tool. All topics with recommendations from included guidelines were identified and categorized. For each subtopic, a conclusion was made followed by the degree of consensus and the highest level of evidence.
RESULTS: Twenty-one guidelines were included. The majority recommended that structured follow-up should be offered, except for patients in whom treatment of recurrence would be inappropriate. It was generally agreed that clinical visits, measurement of carcinoembryoinc antigen and liver imaging should be part of follow-up, based on a high level of evidence, although the frequency is controversial. There was also consensus on imaging of the chest and pelvis in rectal cancer, as well as endoscopy, based on lower levels of evidence and with a level of intensity that was contradictory.
CONCLUSION: In available guidelines, multimodal follow-up after treatment with curative intent of colorectal cancer is widely recommended, but the exact content and intensity are highly controversial. International agreement on the optimal follow-up schedule is unlikely to be achieved on current evidence, and further research should refocus on individualized 'patient-driven' follow-up and new biomarkers.
Journal Article, Review
392-416
Bastiaenen, V.P.
ffbe05ca-75ff-4b08-a7d4-f903006dd33b
Hovdenak Jakobsen, I.
26c998c4-695a-411b-97e4-bacb953719cf
Labianca, R.
b14698b2-49b5-4af0-b34b-dd4f465d1c0b
Martling, A.
5620043e-e94e-46ce-9916-53e1c58822cb
Morton, D.G.
6dc670d6-cbc0-4509-9140-106436dc91a6
Primrose, J.N.
d85f3b28-24c6-475f-955b-ec457a3f9185
Tanis, P.J.
c1b36044-f2e7-4add-988c-39bdc5083f70
Laurberg, S.
a122913a-1c40-496c-997d-48c12d0fa107
Research Committee and the Guidelines Committee of the European Society of Coloproctology (ESCP)
1 April 2019
Bastiaenen, V.P.
ffbe05ca-75ff-4b08-a7d4-f903006dd33b
Hovdenak Jakobsen, I.
26c998c4-695a-411b-97e4-bacb953719cf
Labianca, R.
b14698b2-49b5-4af0-b34b-dd4f465d1c0b
Martling, A.
5620043e-e94e-46ce-9916-53e1c58822cb
Morton, D.G.
6dc670d6-cbc0-4509-9140-106436dc91a6
Primrose, J.N.
d85f3b28-24c6-475f-955b-ec457a3f9185
Tanis, P.J.
c1b36044-f2e7-4add-988c-39bdc5083f70
Laurberg, S.
a122913a-1c40-496c-997d-48c12d0fa107
Bastiaenen, V.P., Hovdenak Jakobsen, I., Labianca, R., Martling, A., Morton, D.G., Primrose, J.N., Tanis, P.J. and Laurberg, S.
,
Research Committee and the Guidelines Committee of the European Society of Coloproctology (ESCP)
(2019)
Consensus and controversies regarding follow-up after treatment with curative intent of nonmetastatic colorectal cancer: a synopsis of guidelines used in countries represented in the European Society of Coloproctology.
Colorectal Disease, 21 (4), .
(doi:10.1111/codi.14503).
Abstract
AIM: It is common clinical practice to follow patients for a period of years after treatment with curative intent of nonmetastatic colorectal cancer, but follow-up strategies vary widely. The aim of this systematic review was to provide an overview of recommendations on this topic in guidelines from member countries of the European Society of Coloproctology, with supporting evidence.
METHOD: A systematic search of Medline, Embase and the guideline databases Trip database, BMJ Best Practice and Guidelines International Network was performed. Quality assessment included use of the AGREE-II tool. All topics with recommendations from included guidelines were identified and categorized. For each subtopic, a conclusion was made followed by the degree of consensus and the highest level of evidence.
RESULTS: Twenty-one guidelines were included. The majority recommended that structured follow-up should be offered, except for patients in whom treatment of recurrence would be inappropriate. It was generally agreed that clinical visits, measurement of carcinoembryoinc antigen and liver imaging should be part of follow-up, based on a high level of evidence, although the frequency is controversial. There was also consensus on imaging of the chest and pelvis in rectal cancer, as well as endoscopy, based on lower levels of evidence and with a level of intensity that was contradictory.
CONCLUSION: In available guidelines, multimodal follow-up after treatment with curative intent of colorectal cancer is widely recommended, but the exact content and intensity are highly controversial. International agreement on the optimal follow-up schedule is unlikely to be achieved on current evidence, and further research should refocus on individualized 'patient-driven' follow-up and new biomarkers.
Text
CDI-00743-2018.R1RM_final word version
- Accepted Manuscript
More information
Accepted/In Press date: 7 November 2018
e-pub ahead of print date: 30 November 2018
Published date: 1 April 2019
Keywords:
Journal Article, Review
Identifiers
Local EPrints ID: 427493
URI: http://eprints.soton.ac.uk/id/eprint/427493
ISSN: 1462-8910
PURE UUID: 250ffd43-790f-411f-bdb5-ad89ac139402
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Date deposited: 21 Jan 2019 17:30
Last modified: 16 Mar 2024 07:31
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Contributors
Author:
V.P. Bastiaenen
Author:
I. Hovdenak Jakobsen
Author:
R. Labianca
Author:
A. Martling
Author:
D.G. Morton
Author:
P.J. Tanis
Author:
S. Laurberg
Corporate Author: Research Committee and the Guidelines Committee of the European Society of Coloproctology (ESCP)
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