Intensive follow-up strategies after radical surgery for nonmetastatic colorectal cancer: A systematic review and meta-analysis of randomized controlled trials

Yaqin Zhao, Cheng Yi, Yu Zhang, Fang Fang and Andrew Faramand

PLOS ONE, 2019, vol. 14, issue 7, 1-14

Abstract: Background: Intensive follow-up after surgery for colorectal cancers is common in clinical practice, but evidence of a survival benefit is limited. Objective: To conduct a systematic review and meta-analysis on the effects of follow-up strategies for nonmetastatic colorectal cancer. Data sources: We searched Medline, Embase, and CENTRAL databases through May 30, 2018. Study selection: We included randomized clinical trials evaluating intensive follow-up versus less follow-up in patients with nonmetastatic colorectal cancer. Interventions: Intensive follow-up Main outcomes measures: Overall survival. Results: The analyses included 17 trials with a total of 8039 patients. Compared with less follow-up, intensive follow-up significantly improved overall survival in patients with nonmetastatic colorectal cancer after radical surgery (HR 0.85, 95% CI 0.74–0.97, P = 0.01; I2 = 30%; high quality). Subgroup analyses showed that differences between intensive-frequency and intensive-test follow-up (P = 0.04) and between short interval and long interval of follow-up (P = 0.02) in favor of the former one. Limitations: Clinical heterogeneity of interventions Conclusions: For patients with nonmetastatic colorectal cancer after curative resection, intensive follow-up strategy was associated with an improvement in overall survival compared with less follow-up strategy. Intensive-frequency follow-up strategy was associated with a greater reduction in mortality compared with intensive-test follow-up strategy.

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0220533

DOI: 10.1371/journal.pone.0220533

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