Nonphysician Clinicians in the Follow-Up of Resected Patients with Colorectal Cancer
| Autor: | Robert R. J. Coebergh van den Braak, Zarina S. Lalmahomed, Bettina E. Hansen, Jan N. M. IJzermans, Stefan Büttner |
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| Přispěvatelé: | Surgery, Public Health |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer Disease Kaplan-Meier Estimate Resection 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Multifocal disease Internal medicine Physicians medicine Overall survival Humans 030212 general & internal medicine Aged Netherlands Proportional Hazards Models business.industry Hazard ratio Gastroenterology General Medicine medicine.disease Curative treatment 030220 oncology & carcinogenesis Population Surveillance Multivariate Analysis Patient Compliance Female Neoplasm Recurrence Local business Colorectal Neoplasms Follow-Up Studies |
| Zdroj: | Digestive Diseases, 36(1), 17-25. Karger |
| ISSN: | 1421-9875 0257-2753 |
| Popis: | Background/Aims: The 5-year postoperative follow-up for patients undergoing curative treatment for colorectal cancer (CRC) is labour intensive. We assessed the added value of a dedicated nonphysician clinician (NPC) in the follow-up of patients after resection for CRC. Methods: Patients were divided into 2 groups as defined by the number of follow-up visits in the first year, including intensive (≥3×) and minimal (≤2×). Involvement of an NPC, diagnosis of disease recurrence and the course of the disease were determined. Results: Of the 681 patients, 79.9% belonged to the “intensive” and 21.1% to the “minimal” group. Involvement of an NPC resulted in a higher adherence to follow-up (84.3 vs. 73.9%, p = 0.001). Overall, patients in regular follow-up less often had multifocal recurrence (47.1 vs. 73.7%, p = 0.04), and a better survival after recurrence (SAR; hazard ratio [HR] 3.604, p < 0.001). The “intensive” group had a significantly better overall survival compared to the “minimal” group (HR 1.71, p = 0.013). Conclusion: Adherence to surveillance programs after resection for CRC is better in hospitals with a dedicated NPC. Overall, patients' adherence to follow-up resulted in less multifocal disease recurrence at the time of diagnosis as compared to patients presenting with symptoms and a better 3-year SAR. |
| Databáze: | OpenAIRE |
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