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Effect of High-Versus Low-Frequency of Abdominopelvic Computed Tomography Follow-Up Testing on Overall Survival in Patients With Stage II Or III Colon Cancer

Authors
 Jeongseok Jeon  ;  Da Bin Lee  ;  Sang Joon Shin  ;  Dai Hoon Han  ;  Jee Suk Chang  ;  Yoon Dae Han  ;  Hyunwook Kim  ;  Joon Seok Lim  ;  Han Sang Kim  ;  Joong Bae Ahn 
Citation
 CLINICAL COLORECTAL CANCER, Vol.22(3) : 307-317, 2023-09 
Journal Title
CLINICAL COLORECTAL CANCER
ISSN
 1533-0028 
Issue Date
2023-09
MeSH
Colonic Neoplasms* / diagnostic imaging ; Colonic Neoplasms* / pathology ; Colonic Neoplasms* / therapy ; Follow-Up Studies ; Humans ; Neoplasm Staging ; Retrospective Studies ; Tomography, X-Ray Computed
Keywords
Postoperative surveillance ; Prognosis ; Recurrence ; Risk factor ; Surveillance
Abstract
Background: Intensive surveillance of colon cancer by using the abdominopelvic computed tomography (AP-CT) is common in real world practice; however, it is still unclear whether high-frequency surveillance using AP-CT in patients with these risk factors is superior to that in the low-frequency surveillance.

Patients and methods: We retrospectively reviewed 1803 patients with stage II-III colon cancer receiving curative surgery between January 1, 2005 to December 31, 2015. We evaluated the average scan-to-scan intervals of postoperative AP-CT testing and assigned patients with an interval of 5 to 8 and 9 to 13 months to the high-frequency (HF) and low-frequency (LF) groups, respectively. The cutoff value of preoperative and postoperative CEA levels was 5 ng/mL. We also applied propensity score matching (PSM) and inverse probability of treatment weighting to adjust clinicopathologic differences between the 2 groups.

Results: We matched 1:1 for each surveillance group yielding a cohort of 776 matched patients. After PSM, Baseline demographics were overall well balanced between 2 groups. Stage III (OR, 2.00; 95% Confidence interval [CI], 1.21-3.30) and postoperative CEA elevation (OR, 2.30; 95% CI, 1.08-4.92) were independent risk factors of recurrence in multivariate analyses. Patient in the HF group had more surgery plus chemo- or radiotherapy as postrecurrence treatment than patient in the LF group (46.2% vs. 23.1%, P = .017). This trend was retained after PSM, although it is not significant (44.4% vs. 23.1%, P = .060). However, survival outcomes of high-frequency AP-CT surveillance were not superior to those of low-frequency surveillance in all subgroups, including stage III (HR 0.99, 95% CI 0.40-2.47) and postoperative CEA elevation (HR 1.36, 95% CI 0.45-4.11).

Conclusion: High-frequency AP-CT testing is associated with a higher proportion of surgery plus chemo- or radiotherapy as postrecurrence treatment, without improvement in 6-year overall survival.
Full Text
https://www.sciencedirect.com/science/article/pii/S1533002823000488
DOI
10.1016/j.clcc.2023.05.003
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Han Sang(김한상) ORCID logo https://orcid.org/0000-0002-6504-9927
Kim, Hyun Wook(김현욱) ORCID logo https://orcid.org/0000-0002-4274-7562
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
Han, Yoon Dae(한윤대) ORCID logo https://orcid.org/0000-0002-2136-3578
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196733
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