Table 1.
Intensive versus Standard Surveillance: Results of Five Prospective Randomized Trials
| N Intensive Standard | First Recurrence (Months) Intensive Standard | 5-Year Survival (%) Intensive Standard | ||||
|---|---|---|---|---|---|---|
| Ohlsson et al4 Intensive protocol: | 53 | 54 | 20.4 | 24 (NS) | 75 | 67 (NS) |
| –H&P with CBC, FOBT, CEA, cxr every 3 mo × 2 y, then every 6 mo | ||||||
| –Annual colonoscopy and computed tomography | ||||||
| –Hepatic ultrasound every 6 mo | ||||||
| –Sigmoidoscopy every 3 mo for rectal and sigmoid | ||||||
| cancers Standard protocol: | ||||||
| –H&P with CBC, FOBT, CEA, cxr every 3 mo × 2 y, then every 6 mo | ||||||
| –Annual barium enema | ||||||
| –Sigmoidoscopy every 3 mo for rectal cancers | ||||||
| Makela et al10 Intensive protocol: | 52 | 54 | 10 | 15 (p = 0.002) | 59 | 54 (NS) |
| –H&P with CBC, FOBT, CEA, cxr every 3 mo × 2 y, then every 6 mo | ||||||
| –Colonoscopy at 3,15,30, & 60 mo | ||||||
| Computed tomography after APR at 3,6,12,18, & 24 mo | ||||||
| Standard protocol: | ||||||
| –No scheduled follow-up | ||||||
| –FOBT samples delivered to clinic every 3 mo × 2 y, then annually | ||||||
| Schoemaker et al11 Intensive protocol: | 167 | 158 | Not | evaluated | 76 | 70 (NS) |
| –H&P with CBC, FOBT, LFTs,CEA every 3 mo × 2 y, then every 6 mo | ||||||
| –Colonoscopy annually | ||||||
| –Computed tomography and cxr annually Standard protocol: | ||||||
| –H&P with CBC, FOBT, LFTs,CEA every 3 mo × 2 y, then every 6 mo | ||||||
| Pietra et al16 Intensive protocol: | 104 | 103 | 10.3 | 20.2 (p < 0.0003) | 73.1 | 58.3 (p < 0.02) |
| –H&P with CEA and hepatic ultrasound every 3 mo × 2 y, then every 6 mo | ||||||
| –Annual colonoscopy, cxr and computed tomography Standard protocol: | ||||||
| –H&P with CEA and hepatic ultrasound every 6 mo × 1 year, then annually | ||||||
| –Annual colonoscopy and cxr | ||||||
| Kjeldsen et al18 Intensive protocol: | 290 | 307 | 18 | 27 (p < 0.001) | 70 | 68 (NS) |
| –H&P with CBC, FOBT, ESR, LFTs, colonoscopy and cxr every 6 mo × 3 y, every 12 mo × 2 y, then every 5 y | ||||||
| Standard protocol: | ||||||
| –H&P with CBC, FOBT, ESR, LFTs, colonoscopy and cxr at 5 and 10 y | ||||||
H&P, history and physical examination; CBC, complete blood count; FOBT, fecal occult blood test; CEA, carcinoembryonic antigen; APR, abdominoperineal resection; LFTs, liver function tests; cxr, chest x-ray; ESR, erythrocyte sedimentation rate; NS, not significant.