Abstract
After curative resection of colorectal cancer, around 5–15% of patients develop a local relapse. The main challenge is to detect these local recurrences when they are still curable. Surveillance after colorectal cancer surgery is therefore of benefit only when survival can be improved. There is no strong evidence at which frequency follow-up visits should be done and with which tools. According to current guidelines, routine surveillance in patients with rectal cancer should at least include regular clinical examination, CEA testing and some sort of liver imaging. In patients with an increased risk for local recurrence (based on prognostic factors, elevated CEA levels or clinical symptoms), imaging is justified and CT is the technique of first choice. In case of equivocal CT findings, PET is more beneficial in identifying a local relapse. The main role of MRI is to establish the resectability of a local tumour recurrence once it has been diagnosed.
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Abbreviations
- ASCO:
-
American Society of Clinical Oncology
- CEA:
-
Carcinoembryonic Antigen
- CT:
-
Computed Tomography
- DCE:
-
Dynamic Contrast Enhanced
- DWI:
-
Diffusion-Weighted (magnetic resonance) Imaging
- ESMO:
-
European Society of Medical Oncology
- FACS (trial):
-
Follow-up After Colorectal Surgery
- GILDA (trial):
-
Gruppo Italiano di Lavoro per la Diagnosi Anticipata
- MRI:
-
Magnetic Resonance Imaging
- PET/FDG-PET:
-
Positron Emission Tomography/18F-fluorodeoxygenase-Positron Emission Tomography
- RCT:
-
Randomised Controlled Trial
- TME:
-
Total Mesorectal Excision
- TNM:
-
Tumour Node Metastasis
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Lambregts, D.M.J., Beets-Tan, R.G.H. (2012). How Can We Identify Local Relapse?. In: Valentini, V., Schmoll, HJ., van de Velde, C. (eds) Multidisciplinary Management of Rectal Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25005-7_11
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DOI: https://doi.org/10.1007/978-3-642-25005-7_11
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