Abstract
It is very important to detect recurrent colorectal cancer after resection of the primary focus, since it has been reported that the survival rate of the recurrent cases increase with the appropriate treatment of recurrent tumor including surgical resection according to the extent of recurrence.
One hundred and thirty-one patients with previously untreated carcinoma of the large bowel were retrospectively evaluated about recurrences in order to find out the most appropriate follow-up schedule. The operations for these patients were curative or relatively non-curative and they were performed between 1982 and 1984. They were followed up carefully until the end of 1986. Twenty patients (15.3%) of these had recurrences and 85% of these recurrences occurred within the first 2 years after the primary resection. The sites of recurrences were liver in 40% of the cases, followed by lung in 30%, lymph node in 30% and local perineum in 20%. Fifty-five percent of the 20 recurrent patients was asymptomatic when the tumor was detected. Recurrent foci of the disease were found on routine chest x-ray examination and blood analysis as well as CEA level in serum.
Thus, we recommend the follow-up schedule as follows; Serial CEA determinations are recommended once a month for the first postoperative year and every 3 months after one year and every 6 months after 2 years, and chest x-ray and ultrasonic examinations should also be performed every 6 months. Whether specific symptoms may exist or not, these follow-up plans must be routinely executed.
