Table 6.
Rectal cancer: Postoperative follow-up.
| NCCN a Recommendations | ESMO b Recommendations | JSCCR c Recommendations | |
|---|---|---|---|
| History and physical examination | every 3–6 months for 2 years, then every 6 months for a total of 5 years | every 6 months for 2 years | every 3 months for 3 years, then every 6 months for a total of 5 years digital rectal examination every 6 months for 3 years |
| Tumour markers | CEA, as above | every 6 months in the first 3 years |
every 6 months for 3 years, then annually for 2 years |
| CT chest-abdomen-pelvis | every 6–12 months for a total of 5 years (stage IV: every 3-6 months for the first 2 years) |
minimum of two scans in the first 3 years | every 6 months for 3 years, then annually for a total of 5 years Stage III: every 6 months for 5 years |
| Colonoscopy | at 1 year after surgery (except if no preoperative colonoscopy due to obstructing lesion, colonoscopy in 3–6 months). Further colonoscopy intervals determined by findings at 1 year | completion colonoscopy within the first year if not done pre-operatively colonoscopy with resection of colonic polyps every 5 years up to age 75 years |
annually for 3 years |
| Additional comments | Proctoscopy (with EUS), MRI every 3–6 months for a total of 5 years, for patients treated with transanal excision only | In patients who underwent a complete resection of metastatic disease, a more intensive follow-up should be considered: a follow-up with CEA and CT scan at intervals of 3–6 months during the first 3 years can be recommended | In R1 resection, close surveillance schedule should be planned for organs in which residual cancer is suspected |
Adapted with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Guideline Rectal Cancer V.1.2022. © 2022 National Comprehensive Cancer Network, Inc. All rights reserved. The NCCN Guidelines® and illustrations herein may not be reproduced in any form for any purpose without the express written permission of NCCN. To view the most recent and complete version of the NCCN Guidelines, go online to NCCN.org. The NCCN Guidelines are a work in progress that may be refined as often as new significant data become available; CEA = carcinoembryonic antigen; ERUS = endoscopic rectal ultrasound; CRC = colorectal cancer; a NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) [14]; b European Society of Medical Oncology (ESMO) guidelines [16]; c Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines [18].