Surgical rather than endoscopic resection of early-stage colorectal cancers promotes excessive imaging surveillance - 11/11/21
, Christine Piette c, Chloé Rousseau d, Thomas Grainville a, Mathilde Cosson c, Astrid Lièvre a, b, c, eBenvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
| pagine | 9 |
| Iconografia | 0 |
| Video | 0 |
| Altro | 0 |
Highlights |
• | Little is known about the use of imaging surveillance after curative resection of early-stage colorectal cancer. |
• | Imaging surveillance was analyzed in a cohort of 450 patients with screening-detected stage 0 or stage 1 colorectal cancers. |
• | Imaging surveillance was performed for 159 (35.3%) patients, more often for those with stage 1 (66.5%) than stage 0 (14.2%) tumours. |
• | Factors associated with imaging monitoring were the gastroenterologist assigned to the patient and surgical vs endoscopic resection. |
• | This study highlights the abusive and paradoxical nature of imaging surveillance in patients undergoing surgery. |
Abstract |
Background and aims |
: Imaging surveillance after curative resection of colorectal cancer (CRC) is debated, particularly in cases of early-stage CRC. The aim of this study was to retrospectively analyze whether and how patients with screened stage 0 and stage 1 CRC were monitored by imaging.
Methods |
A cohort of patients with stage 0 (intramucosal) or stage 1 (T1N0) CRC detected from 2003 to 2015 through the French national screening programme was included. All imaging findings were recorded. Statistical analyses were performed for the entire cohort (n = 450) and separately for the two groups (stage 0 n = 268, stage 1 n = 182). Factors associated with imaging surveillance, including the patient's referring gastroenterologist, were determined by logistic regression.
Results |
A total of 450 patients were followed up for 6.6 ± 3.9 years. Imaging surveillance was performed for 159 (35.3%), more often for those with stage 1 (66.5%) than stage 0 (14.2%) tumours (p < 0.0001). Within the stage 1 group, 17 of the 47 patients (36.2%) treated by local (endoscopic or surgical transanal) resection alone were followed up by imaging monitoring. Factors significantly associated with surveillance in the entire cohort were the gastroenterologist assigned to the patient (p < 0.0001) and surgical vs endoscopic resection (OR = 39.0, p < 0.0001). The histological risk of lymph node metastasis was not significantly associated with imaging monitoring for stage 1 patients. Of the 5 patients who developed distant metastasis during follow-up, one was diagnosed through imaging surveillance.
Conclusion |
This study demonstrates excessive imaging surveillance for early-stage cancers. The use of surgical over endoscopic tumour resection could promote unnecessary surveillance.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : CRC, CT, US, IMC, UICC, OR, CI, 18-FDG PET
Keywords : Early-stage colorectal cancer, Endoscopic therapy, Surgical treatment, Colorectal cancer screening, Imaging surveillance
Mappa
Vol 45 - N° 6
Articolo 101735- Novembre 2021 Ritorno al numero
Articolo precedente
- A guide for assessing the clinical relevance of findings in small bowel capsule endoscopy: analysis of 8064 answers of international experts to an illustrated script questionnaire
- R. Leenhardt, A. Koulaouzidis, D. McNamara, M. Keuchel, R. Sidhu, M.E. McAlindon, J.C. Saurin, R. Eliakim, I. Fernandez-Urien Sainz, J.N. Plevris, G. Rahmi, E. Rondonotti, B. Rosa, C. Spada, E. Toth, C. Houdeville, C. Li, M. Robaszkiewicz, P. Marteau, X. Dray
- TSHZ3 functions as a tumor suppressor by DNA methylation in colorectal cancer
- Youxin Zhou, Sentai Wang, Xuequn Yin, Guanzhuang Gao, Qiang Wang, Qiaoming Zhi, Ye Han, Yuting Kuang
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?