Annual computed tomography scans do not improve outcomes following esophagectomy for cancer: a 10-year UK experience.

Autor: Antonowicz SS; Upper GI Surgery, Department of Surgery, Mid-Essex Healthcare NHS Trust, Chelmsford, Essex, UK., Lorenzi B, Parker M, Tang CB, Harvey M, Kadirkamanathan SS
Jazyk: angličtina
Zdroj: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2015 May-Jun; Vol. 28 (4), pp. 365-70. Date of Electronic Publication: 2014 Mar 20.
DOI: 10.1111/dote.12209
Abstrakt: Evidence for the best approach to follow-up patients after esophagectomy for cancer is scant and conflicting, and has led to a wide variety in practice. The aim of this study was to evaluate whether our annual routine computed tomography (aCT) scan program changes outcomes. A retrospective review of 169 patients who underwent esophagectomy for cancer in our unit between 2001 and 2010 was performed. aCT scan was part of follow-up in all patients to 5 years. Minimum follow-up was 37 months. The primary outcome measure was survival. Recurrence was detected in 61 cases (36%). aCT scan diagnosed recurrence in only a minority of cases (17 cases, 28%). In the majority of patients, clinical evidence prompted an unplanned CT scan (uCT; 44 cases, 72%). There was no difference in unadjusted survival between the two groups (hazard ratio = 0.61, 95% confidence interval 0.34-1.08, P = 0.090), nor was one more likely to receive secondary oncological treatment (aCT 41% vs. uCT 44%, P = 1.000). When we adjusted survival patterns for confounding covariates, the uCT cohort showed a protective effect (hazard ratio = 0.54, 95% confidence interval 0.28-0.98, P = 0.042). These data suggest that aCT scans do not influence management or survival after esophagectomy. A consensus follow-up protocol for patients treated for esophageal cancer remains to be established.
(© 2014 International Society for Diseases of the Esophagus.)
Databáze: MEDLINE
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