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Postoperative Follow-Up for Colorectal Cancer – What is Left?

A local recurrence or single metastases from colorectal cancer may be detected with a considerable time lead by an intensive follow-up regimen. Some of these recurrences may again be cured by surgery or multimodal therapies. However, the proportion of patients that will actually benefit from the earlier detection of the tumor relapse is small. It is generally believed that by an early surgery of local recurrence and metastases, life prolongation or recovery can be achieved in 5–15% of patients. A prerequisite for this, however, is an R0 resection of the local recurrence or solitary liver or lung metastases. It is still unknown how intensive a postoperative follow-up should be in order to make this therapy option available to the highest possible proportion of patients. Undoubtedly, the postoperative follow-up diagnosis must lead to therapeutic action if optimum results are to be achieved. Thus, intensive postoperative follow-up is only justified if the expected pattern of recurrence and the individual patients health condition would allow significant therapeutic consequences in case of such recurrence. The costs of the postoperative follow-up are high, particularly because so far no optimum follow-up concept can be formulated. Therefore, it is necessary to further evaluate this point under a clear and prospective trial conception, as only by such evaluation postoperative follow-up can be maintained in the future under economic aspects. This is also necessary for quality assurance as well as it is the basis for the development of new therapeutic methods. The factors which have to be considered in this context will be put forward and analyzed in the following article.