No benefit of more intense follow-up after surgery for colorectal cancer in the risk group with elevated CEA levels – An analysis within the COLOFOL randomized clinical trial
| Autor: | Monika Egenvall, Anna Martling, Katalin Veres, Erzsébet Horváth-Puhó, Peer Wille-Jørgensen, Sune Høirup Petersen, Søren Laurberg, Henrik Toft Sørensen, Ingvar Syk, Per Vadgaard Andersen, Henrik Christensen, Jesper Dan Nielsen, Per Jess, Mogens Rørbæk Madsen, Allan Gorm Pedersen, Erling Østergaard, Pernilla Hansdotter Andersson, Jonas Bengtsson, Mats Bragmark, Pamela Buchwald, Parastau Farahnak, Joakim Folkesson, Lars Påhlman, Michael Goldinger, Rolf Heuman, Kenneth Lindberg, Pia Näsvall, Johan Ottosson, Birger Sandzén, Carlos Barberousse, Andrew Renehan, Kenneth Smedh |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Thorax
Male medicine.medical_specialty Colorectal cancer Aftercare STAGE-II Adenocarcinoma law.invention 03 medical and health sciences Post-hoc analysis 0302 clinical medicine Carcinoembryonic antigen Randomized controlled trial law Risk Factors Medicine Humans 030212 general & internal medicine RECURRENCE Aged Proportional Hazards Models biology business.industry Follow-up Hazard ratio General Medicine Middle Aged medicine.disease Confidence interval Surgery Carcinoembryonic Antigen Clinical trial PROGNOSTIC VALUE Regimen Oncology 030220 oncology & carcinogenesis biology.protein Female Neoplasm Recurrence Local business Colorectal Neoplasms Tomography X-Ray Computed |
| Zdroj: | Egenvall, M, Martling, A, Veres, K, Horváth-Puhó, E, Wille-Jørgensen, P, Høirup Petersen, S, Laurberg, S, Sørensen, H T, Syk, I, Nielsen, J D & The COLOFOL Study Group 2021, ' No benefit of more intense follow-up after surgery for colorectal cancer in the risk group with elevated CEA levels – An analysis within the COLOFOL randomized clinical trial ', European Journal of Surgical Oncology, vol. 47, no. 8, pp. 2053-2059 . https://doi.org/10.1016/j.ejso.2021.03.235 Egenvall, M, Martling, A, Veres, K, Horváth-Puhó, E, Wille-Jørgensen, P, Høirup Petersen, S, Laurberg, S, Sørensen, H T, Syk, I & The COLOFOL Study Group 2021, ' No benefit of more intense follow-up after surgery for colorectal cancer in the risk group with elevated CEA levels – An analysis within the COLOFOL randomized clinical trial ', European Journal of Surgical Oncology, vol. 47, no. 8, pp. 2053-2059 . https://doi.org/10.1016/j.ejso.2021.03.235 Egenvall, M, Martling, A, Veres, K, Horváth-Puhó, E, Wille-Jørgensen, P, Høirup Petersen, S, Laurberg, S, Sørensen, H T, Syk, I, The COLOFOL Study Group, Andersen, P V, Christensen, H & Nielsen, J D 2021, ' No benefit of more intense follow-up after surgery for colorectal cancer in the risk group with elevated CEA levels – An analysis within the COLOFOL randomized clinical trial ', European Journal of Surgical Oncology, vol. 47, no. 8, pp. 2053-2059 . https://doi.org/10.1016/j.ejso.2021.03.235 |
| Popis: | Background Patients with colorectal cancer were examined to determine (1) whether elevated carcinoembryonic antigen (CEA) levels, either before treatment or after surgery, was associated with an increased risk of overall or colorectal cancer-specific mortality or recurrence, and (2) whether high intensity follow-up would benefit those patients. Materials and methods Post-hoc analysis based on 2509 patients that underwent surgery for colorectal cancer, stage II or III, in the COLOFOL randomized trial with 5-year follow-up. Serum CEA levels were ascertained before treatment and one month after surgery. Follow-up examinations included computed tomography of the thorax and abdomen and serum CEA sampling. Patients were randomized to examinations at either 6, 12, 18, 24, and 36 months (high-intensity group) or at 12 and 36 months after surgery (low-intensity group). Levels of CEA >5 μg/l were defined as elevated. Results Elevated CEA levels before treatment were associated with increased risk of recurrence (hazard ratio [HR], 1.49; 95% confidence interval [CI]: 1.22–1.83), colorectal cancer-specific mortality (HR, 1.44; 95% CI: 1.08–1.91), and overall mortality (HR, 1.38; 95% CI: 1.07–1.78). Elevated CEA levels after surgery were associated with increased colorectal cancer-specific mortality (HR, 1.68; 95% CI: 1.08–2.61) and overall mortality (HR, 1.79; 95% CI: 1.22–2.63). The intensity of the follow-up regimen had no effect on 5-year outcomes in patients with elevated CEA levels. Conclusion Both pre-treatment and post-surgery elevated serum CEA levels were associated with increased overall and cancer-specific mortality. Intensified follow-up showed no benefit over low-intensity follow-up in this high-risk group of patients with elevated CEA levels. |
| Databáze: | OpenAIRE |
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