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[Patient selection and efficacy of tumor after-care in surgically treated colorectal carcinoma].

Scheduled follow-up after surgically treated colorectal cancer remains controversial because eventually only about 5% of patients profit from it. Careful selection should therefore spare those patients unnecessary investigations who are least likely to benefit from follow-up. Only patients should be considered whose tumor was completely resected and who were found free of distant metastases. These patients should be fully informed about their disease and accept scheduled investigation even if asymptomatic. A questionable operability with regard to a second surgical intervention forbids formal entry into a follow-up program as well as a decreased life expectancy due to other disease. The family physician is most qualified to carry out or coordinate these investigations. For the first two postoperative years intervals of three and for the further three years of six months are recommended. Physical examination and determination of CEA titers are the essential measures; colonoscopy, sonography, CT scans, chest X-ray, and for rectal cancer, endoluminal sonography are undertaken periodically. In such a selected cohort one can expect a resectable recurrence in 25% of patients, of which 20% can be cured.