Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton 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

 26 May 2015

Advanced search
 26 May 2015 
Calcium channel blockers and GI bleeds
 26 May 2015 

Risk factors for celiac disease

 26 May 2015 
Antimicrobials for intraabdominal infection
 25 May 2015 
Risk of GI bleeds with NSAIDs
 25 May 2015 
Colorectal cancer screening
 25 May 2015 
Saccharomyces boulardii and H. pylori
 22 May 2015 
Treatment with anti-integrin antibodies in IBD
 22 May 2015 
Care of patients with GERD
 22 May 2015 
Colonoscopy screening for colorectal cancer
 21 May 2015 
Imaging for hepatocellular carcinoma
 21 May 2015 
Lymphoma in IBD
 21 May 2015 
Serrated polyps and colorectal cancer
 20 May 2015 
Refractory metastatic colorectal cancer
 20 May 2015 
Surveillance in long-segment Barrett's
 20 May 2015 
Pancreatic neuroendocrine tumors
 19 May 2015 
PPIs and cryptogenic liver abscess
 19 May 2015 
Anti-integrin antibodies in IBD
 19 May 2015 
Metabolic syndrome and Barrett's
 18 May 2015 
HLA haplotypes and primary sclerosing cholangitis
 18 May 2015 
Safety of PPI
 18 May 2015 
ESPGHAN celiac guidelines
 15 May 2015 
Management of nonhospitalized ulcerative colitis
 15 May 2015 
Diabetes and infections in IBD with immunomodulation
 15 May 2015 
Microscopic colitis risk with PPIs/NSAIDs
 14 May 2015 
Diagnosis of spontaneous bacterial peritonitis
 14 May 2015 
Mortality in US patients with cirrhosis
 14 May 2015 
Radiation exposure during ERCP
 13 May 2015 
Predictors of IBD
 13 May 2015 
Psychological distress and liver disease mortality
 13 May 2015 
Hypnotherapy in IBS/IBD
 12 May 2015 
Bleeding in NSAID users with H.pylori
 12 May 2015 
Capsule colonoscopy detects colorectal polyps
 12 May 2015 
Anti-TNF biologics in acute severe ulcerative colitis
 11 May 2015 
Management of Barrett's esophagus
 11 May 2015 
Marker to detect recurrence of Crohn's
 11 May 2015 
Thalidomide for IBD
 08 May 2015 
Surveillance colonoscopy in colorectal cancer
 08 May 2015 
HCV treatment with compensated cirrhosis
 08 May 2015 
Medical management of Crohn's
 07 May 2015 
Surgical complications in ulcerative colitis
 07 May 2015 
Combination therapy for noncirrhostic patients
 07 May 2015 
Anxiety and new-onset dyspepsia
 06 May 2015 
PPIs and spontaneous bacterial peritonitis
 06 May 2015 
Infant feeding and celiac disease
 06 May 2015 
Preventing recurrent C. diff infection
 05 May 2015 
Fatigue in primary sclerosing cholangitis
 05 May 2015 
Annual CT scans after esophagectomy for cancer
 05 May 2015 
Prevalence of eosinophilic esophagitis
 04 May 2015 
Stress resilience and peptic ulcer disease
 04 May 2015 
Endoscope storage and microbial colonization
 04 May 2015 
Menarche and NAFLD
 01 May 2015 
Sleep and physical activity measured in Crohn's
 01 May 2015 
NAFLD progression from steatosis to fibrosing-steatohepatitis
 01 May 2015 
Dietary supplement hepatotoxicity
 30 April 2015 
Risk factors for primary sclerosing cholangitis
 30 April 2015 
Neoadjuvant chemoradiotherapy for esophageal cancer
 30 April 2015 
Botulinum toxin A for the treatment of obesity
 29 April 2015 
Hepatocellular carcinoma surveillance in HBV
 29 April 2015 
Liver enzyme elevations after anti-TNF therapy in IBD

 29 April 2015 
Response to sorafenib in hepatocellular carcinoma

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us