Table 3.
Deferral of surgery follow-up protocol
| Time line from end of CRT | Visit window | Clinic OPAb | PROMc | Scans | Endoscopy |
|---|---|---|---|---|---|
| 6 monthsa,d | ±1 month | X | MRI | Flex sig | |
| 9 monthsd | ± 1 month | X | MRI | Flex sig | |
| 1 yeard | ± 1 month | X | EORTC QLQ-C30, LARS, EQ-5D | MRI CT |
Colonoscopy |
| 1 year 3 months | ± 1 month | X | |||
| 1 year 6 monthsd | ± 1 month | X | MRI | Flex sig | |
| 1 year 9 months | ± 1 month | X | |||
| 2 yearse | ± 1 month | X | MRI CT |
Flex sig | |
| 2 years 6 monthse | ± 1 month | X | |||
| 3 yearsd | ± 2 months | X | EORTC QLQ-C30, LARS, EQ-5D | MRI CT |
Flex sig |
| 3 years 6 months | ± 2 months | X | |||
| 4 yearsd | ± 2 months | X | MRI | Flex sig | |
| 4 years 6 months | ± 2 months | X | |||
| 5 yearsd | ± 3 months | X | EORTC QLQ-C30, LARS, EQ-5D | MRI | Colonoscopy |
a This visit should take place once the patient has completed chemotherapy. It is recommended that a computed tomography (CT) scan is also performed following the completion of chemotherapy as is usual practice
bEach clinic outpatient appointment (OPA) should include a digital rectal exam and CEA (tumour marker) blood test
cQuality of life Case Record Form (CRF): EORTC QLQ-C30, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, v3; LARS, Low Anterior Resection Syndrome Score; EQ-5D, EuroQol Group five dimensions Health Questionnaire
dIf patient has consented to the additional blood sample collection for research (circulating tumour DNA and markers of cell proliferation and apoptosis) then samples collected during the clinic outpatient appointment, ideally at the same time as the routine blood tests are performed
CRT pre-operative chemoradiotherapy, Flex sig flexible sigmoidoscopy, PROM patient-reported outcome measure