Follow-Up Care, Surveillance Protocol, and Secondary Prevention Measures for Survivors of Colorectal Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement

被引:285
作者
Meyerhardt, Jeffrey A. [1 ]
Mangu, Pamela B. [2 ]
Flynn, Patrick J. [4 ]
Korde, Larissa [6 ]
Loprinzi, Charles L. [5 ]
Minsky, Bruce D. [7 ]
Petrelli, Nicholas J. [8 ]
Ryan, Kim [3 ]
Schrag, Deborah H. [1 ]
Wong, Sandra L. [9 ]
Benson, Al B., III [10 ]
机构
[1] Dana Farber Canc Inst, Boston, MA 02115 USA
[2] Amer Soc Clin Oncol, Alexandria, VA 22314 USA
[3] Fight Colorectal Canc, Alexandria, VA USA
[4] Minnesota Oncol, Minneapolis, MN USA
[5] Mayo Clin, Rochester, MN USA
[6] Univ Washington, Seattle, WA 98195 USA
[7] Univ Texas MD Anderson Canc Ctr, Houston, TX 77030 USA
[8] Helen Graham Canc Ctr, Newark, DE USA
[9] Univ Michigan, Sch Med, Ann Arbor, MI USA
[10] Northwestern Univ, Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
关键词
COLON; UPDATE; DIAGNOSIS; RISK;
D O I
10.1200/JCO.2013.50.7442
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
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页码:4465 / +
页数:8
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