Surveillance after curative treatment for colorectal cancer

Pooled analyses of prospective trials have demonstrated an overall survival benefit of intensive postoperative surveillance in patients with stage I–III colorectal cancer (CRC); however, individual studies used highly heterogeneous surveillance schemesThe overall survival benefit of intensive surveillance is only partly due to improved cancer-specific survival; other contributing factors include the treatment of comorbidities owing to frequent contact with medical professionalsFor patients with stage I–III CRC, no optimal diagnostic tool or frequency of patient visits has been established; regular follow-up assessment by a clinician seem to be the most-important factorColonoscopies are generally performed at 6, 30 and 60 months after curative treatment of patients with stage I–III CRC; performing additional colonoscopies does not improve overall survivalLimited evidence is available regarding surveillance after endoscopic resection of early neoplasia, and after organ-sparing treatment for rectal cancer; prospective randomized trials are neededSimilarly, a lack of evidence exists on the effectiveness of surveillance after treatment of patients with stage IV CRC with curative intent, and thus randomized trials are also needed to address this issue