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Role of surveillance imaging and endoscopy in colorectal cancer follow-up: Quality over quantity?

2019; Baishideng Publishing Group; Volume: 25; Issue: 1 Linguagem: Inglês

10.3748/wjg.v25.i1.59

2219-2840

Shiru Liu, Winson Y. Cheung,

Radiomics and Machine Learning in Medical Imaging

Colorectal cancer (CRC) is a prevalent disease and represents a major cause of morbidity and mortality in the developed world.Intensive post-treatment surveillance is routinely recommended by major expert groups for early stage (II and III) CRC survivors because previous meta-analyses showed a modest, but significant survival benefit.This practice has been recently challenged based on data emerging from several large phase III randomized trials that demonstrated a lack of survival benefit from intensive surveillance strategies.In addition, findings from cost-effectiveness analyses of such an approach are inconsistent.Data on real-world practice, specifically adherence to these follow-up guidelines, are also limited.The debate is especially controversial in resected stage IV patients where there are currently no clear guidelines for follow-up.In an era of personalized medicine, there may be a shift towards a more risk-adapted approach to better define the optimal follow-up strategy.In this article, we review the evidence and highlight the role of surveillance in CRC survivors.