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J Clin Oncol. 2013 Dec 10;31(35):4465-70. doi: 10.1200/JCO.2013.50.7442. Epub 2013 Nov 12.

Follow-up care, surveillance protocol, and secondary prevention measures for survivors of colorectal cancer: American Society of Clinical Oncology clinical practice guideline endorsement.

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  • 1Jeffrey A. Meyerhardt and Deborah H. Schrag, Dana-Farber Cancer Institute, Boston, MA; Pamela B. Mangu, American Society of Clinical Oncology; Kim Ryan, Fight Colorectal Cancer, Alexandria, VA; Patrick J. Flynn, Minnesota Oncology, Minneapolis; Charles L. Loprinzi, Mayo Clinic, Rochester, MN; Larissa Korde, University of Washington, Seattle, WA; Bruce D. Minsky, MD Anderson Cancer Center, Houston, TX; Nicholas J. Petrelli, Helen Graham Cancer Center, Newark, DE; Sandra L. Wong, University of Michigan Medical School, Ann Arbor, MI; and Al B. Benson III, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL.

Abstract

PURPOSE:

The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing recent clinical practice guidelines that have been developed by other professional organizations.

METHODS:

The Cancer Care Ontario (CCO) Guideline on Follow-up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer was reviewed by ASCO for methodologic rigor and considered for endorsement.

RESULTS:

The ASCO Panel concurred with the CCO recommendations and recommended endorsement, with the addition of several qualifying statements.

CONCLUSION:

Surveillance should be guided by presumed risk of recurrence and functional status of the patient (important within the first 2 to 4 years). Medical history, physical examination, and carcinoembryonic antigen testing should be performed every 3 to 6 months for 5 years. Patients at higher risk of recurrence should be considered for testing in the more frequent end of the range. A computed tomography scan (abdominal and chest) is recommended annually for 3 years, in most cases. Positron emission tomography scans should not be used for surveillance outside of a clinical trial. A surveillance colonoscopy should be performed 1 year after the initial surgery and then every 5 years, dictated by the findings of the previous one. If a colonoscopy was not preformed before diagnosis, it should be done after completion of adjuvant therapy (before 1 year). Secondary prevention (maintaining a healthy body weight and active lifestyle) is recommended. If a patient is not a candidate for surgery or systemic therapy because of severe comorbid conditions, surveillance tests should not be performed. A treatment plan from the specialist should have clear directions on appropriate follow-up by a nonspecialist.

PMID:
24220554
[PubMed - indexed for MEDLINE]
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