Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 01 October 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Blood test vs CT to detect recurrence of colorectal cancer

This week's issue of the Journal of the American Medical Association examines the effect of 3 to 5 Years of scheduled CEA and CT follow-up to detect recurrence of colorectal cancer.

News image

Intensive follow-up after surgery for colorectal cancer is common practice but is based on limited evidence.

Professor David Mant and colleagues from the United Kingdom assessed the effect of scheduled blood measurement of carcinoembryonic antigen (CEA) and computed tomography (CT) as follow-up to detect recurrent colorectal cancer treatable with curative intent.

The research team performed a randomized clinical trial in 39 National Health Service hospitals in the United Kingdom.

The team recruited 1202 eligible participants between 2003 and 2009 who had undergone curative surgery for primary colorectal cancer, including adjuvant treatment if indicated, with no evidence of residual disease on investigation.

Participants were randomly assigned to 1 of 4 groups, including 300 patients in the CEA only group, 299 in the CT only group, 302 in the CEA+CT group, and 301 patients in the minimum follow-up group.

Surgical treatment of recurrence with curative intent was 7% in the CEA group
Journal of the American Medical Association

Blood CEA was measured every 3 months for 2 years, then every 6 months for 3 years.

CT scans of the chest, abdomen, and pelvis were performed every 6 months for 2 years, then annually for 3 years.

The team reported that the minimum follow-up group received follow-up if symptoms occurred.

The team's main outcomes included surgical treatment of recurrence with curative intent.

The researcher's secondary outcomes were mortality, time to detection of recurrence, and survival after treatment of recurrence with curative intent.

After a mean 4 years of observation, cancer recurrence was detected in 199 participants overall.

The research team treated 71 of 1202 participants for recurrence with curative intent, with little difference according to Dukes staging.

Surgical treatment of recurrence with curative intent was 2% in the minimum follow-up group, 7% in the CEA group, 8% in the CT group, and 7% in the CEA+CT group.

Compared with minimum follow-up, the absolute difference in the percentage of patients treated with curative intent in the CEA group was 4%, in the CT group was 6%, and in the CEA+CT group was 4%.

The team observed that the number of deaths was not significantly different in the combined intensive monitoring groups vs the minimum follow-up group.

Professor Mant's team concluded, "Among patients who had undergone curative surgery for primary colorectal cancer, intensive imaging or CEA screening each provided an increased rate of surgical treatment of recurrence with curative intent compared with minimal follow-up."

"There was no advantage in combining CEA and CT."

"If there is a survival advantage to any strategy, it is likely to be small."

JAMA 2014; 311(3): 263-270
16 January 2014

Go to top of page Email this page Email this page to a colleague

 30 September 2016 
Gluten breakdown and immunogenicity in celiac disease
 30 September 2016 
Noninvasive detection of NASH
 30 September 2016 
CEA levels to detect recurrent colorectal cancer
 29 September 2016 
Biologic therapies in IBD
 29 September 2016 
Predicting the prognosis of gastric cancer
 29 September 2016 
Predicting symptomatic outcomes in GERD
 28 September 2016 
Hep C virus RNA in liver explants
 28 September 2016 
Global trends in pancreatic cancer mortality
 28 September 2016 
Heterogeneity in endoscopic treatment of Crohn’s
 27 September 2016 
Non-invasive tests of NAFLD
 27 September 2016 
Fecal microbiota transplantation for C.diff in IBD
 27 September 2016 
Fast-track colorectal surgery influences outcomes
 26 September 2016 
Preventing cirrhosis in Hep C with fibrosis
 26 September 2016 
Body image after abdominoperineal excision for rectal cancer
 26 September 2016 
Gastric cancer risk in intestinal metaplasia of the stomach
 23 September 2016 
Sleep quality in nonalcoholic cirrhotic patients
 23 September 2016 
Exercise for NAFLD
 23 September 2016 
BMI history and fatty liver
 22 September 2016 
Predicting small-bowel Crohn’s disease
 22 September 2016 
Colectomy outcomes for ulcerative colitis
 22 September 2016 
Technology vs intervention for weight loss
 21 September 2016 
Employment status and IBD
 21 September 2016 
Cardiopulmonary exercise testing in liver transplant candidates
 21 September 2016 
Patients vs providers on nutrition in IBD
 20 September 2016 
Improving healthcare systems for viral Hepatitis
 20 September 2016 
GI benefits of COX-2 selective inhibitors
 20 September 2016 
Predicting relapse in Crohn's
 19 September 2016 
Prevalence of esophageal cancer in Barrett's
 19 September 2016 
Fecal microbiota transplantation and CDI in IBD
 19 September 2016 
Antibiotic resistance in Helicobacter pylori
 16 September 2016 
Low-residue diet before colonoscopy and bowel cleansing
 16 September 2016 
Genome-wide association in gastric cancer
 16 September 2016 
H. pylori in children with asthma
 15 September 2016 
Improving survival in cholangitis-associated septic shock
 15 September 2016 
Colorectal cancer survival and hospital volumes
 15 September 2016 
Primary sclerosing cholangitis and IBD
 14 September 2016 
Intestinal malabsorption and olmesartan
 14 September 2016 
Infection reduction strategy after colorectal resection
 14 September 2016 
Predicting long-term infliximab use in Crohn's
 13 September 2016 
Predicting survival in refractory celiac disease
 13 September 2016 
Cancer risk stratification in Barrett’s
 13 September 2016 
Screening vs non-screening colonoscopy
 12 September 2016 
Screening in familial colorectal cancer
 12 September 2016 
Metformin improves survival in pancreatic ductal cancer
 12 September 2016 
Consent guidelines for GI endoscopy procedures
 09 September 2016 
Development of IBS
 09 September 2016 
Safe and effective treatment for NASH
 09 September 2016 
Scale for stool measurement in diarrhea-IBS
 08 September 2016 
Prognostic factors for infliximab in Crohn's
 08 September 2016 
Chronic Hep B vs chronic Hep C and mortality
 08 September 2016 
Hematological malignancies in IBD
 07 September 2016 
IBD relapse during pregnancy
 07 September 2016 
New treatments for ulcerative colitis
 07 September 2016 
Alternative to nucleic acid testing in HCV
 06 September 2016 
EHealth technologies in IBD
 06 September 2016 
Endoscopy clinic no-shows
 06 September 2016 
Risk of infection after elective colorectal surgery
 05 September 2016 
Esophageal impedance monitoring
 05 September 2016 
Family history and IBD clinical course
 05 September 2016 
Biomarker for IBD and GI cancer

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us