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Staging and Follow-Up of Colorectal Cancer

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Radiology and Imaging of the Colon

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

The prognosis of any neoplasm is dependant upon its extent of dissemination at the time of initial treatment and the efficacy of available therapies to eliminate all sites of disease. Staging and post-operative surveillance have the common goals of determining the extent of dissemination of the cancer so as to direct treatment. Staging is performed at presentation with the aim of giving a measure of the extent of local and metastatic disease and is now a fundamental part of oncological practice. Post-operative surveillance is performed for two purposes, firstly to identify metachronous tumours for which the patient is at increased risk and secondly to detect residual or recurrent cancer from the original tumour. The latter is much more contentious and is performed to compensate for failures of initial treatment and staging techniques with the intention of initiating further treatment. An understanding of the sites and mechanism of spread is useful in considering both staging and surveillance. The role of radiology for staging and post-operative surveillance of colorectal cancer will be examined. Follow-up to identify second primary tumours is usually performed by colonoscopy and will not be discussed in detail.

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References

  • Ahlquist DA, Weiand HS, Moertel CG et al (1993) Accuracy of fecal occult blood screening for colorectal neoplasia. A prospective study using Hemoccult and HemoQuant tests. JAMA 269:1262–1267

    Article  PubMed  CAS  Google Scholar 

  • Allen-Mersh TG, Earlam S, Fordy C et al (1994) Quality of life and survival with continuous hepatic artery floxuridine infusion for colorectal liver metastases. Lancet 344:1255–1260

    Article  PubMed  CAS  Google Scholar 

  • Arulampalam TH, Costa DC, Loizidou M et al (2001) Positron emission tomography and colorectal cancer. Br J Surg 88: 176–189

    Article  PubMed  CAS  Google Scholar 

  • Audisio RA, Robertson (2000) Colorectal cancer follow-up: perspectives for future studies. Eur J Surg Oncol 26:329–337

    Article  PubMed  CAS  Google Scholar 

  • Audisio RA, Setti-Carraro P, Segala M et al (1996) Follow-up in colorectal cancer patients: a cost-benefit analysis. Ann Surg Oncol 3:349–57

    Article  PubMed  CAS  Google Scholar 

  • August DA, Ottow RT, Sugarbaker PH (1984) Clinical perspective of human colorectal cancer metastasis. Cancer Metast Rev 3:303–324

    Article  CAS  Google Scholar 

  • Baker ME, Pelley R (1995) Hepatic metastases: basic principles and implications for Radiologists. Radiology 197:329–337

    PubMed  CAS  Google Scholar 

  • Bengmark S, Hafström L (1969) The natural history of primary and secondary malignant tumors of the liver. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy. Cancer 23:198–202

    Article  PubMed  CAS  Google Scholar 

  • Benson AB 3rd, Desch CE, Flynn PJ et al (2000) Update of American Society of clinical oncology colorectal surveillance guidelines. J Clin Oncol 8:3586–3588

    Google Scholar 

  • Bergamaschi R, Arnaud JP (1996) Routine compared with nonscheduled follow-up of patients with “curative” surgery for colorectal cancer. Ann Surg Oncol 3:464–469

    Article  PubMed  CAS  Google Scholar 

  • Berman JM, Cheung RJ, Weinberg DS (2000) Surveillance after colorectal cancer resection. Lancet 355:395–399

    Article  PubMed  CAS  Google Scholar 

  • Blomley MJ, Albrecht T, Cosgrove DO et al (1999) Improved imaging of liver metastases with stimulated acoustic emission in the late phase of enhancement with the US contrast agent DHU 508A: early experience. Radiology 210:409–416

    PubMed  CAS  Google Scholar 

  • Bruinvels DJ, Stiggelbout AM, Kievit J et al (1994) Follow-up of patients with colorectal cancer: Ameta-analysis. Ann Surg 219:174–182

    Article  PubMed  CAS  Google Scholar 

  • Bruinvels DJ, Stiggelbout AM, Klaassen MP et al (1995) Follow-up after colorectal cancer: current practice in The Netherlands. Eur J Surg 161:827–831

    PubMed  CAS  Google Scholar 

  • Carter R, Hemingway D, Cooke TG et al (1996) A prospective study of six methods for detection of hepatic colorectal metastases. Ann R Coll Surg Engl 78:27–30

    PubMed  CAS  Google Scholar 

  • Cass AW, Million RR, Pfaff WW (1976) Patterns of recurrence following surgery alone for adenocarcinoma of the colon and rectum. Cancer 37:2861–2865

    Article  PubMed  CAS  Google Scholar 

  • Charnley RM, Morris DL, Dennison AR et al (1991) Detection of colorectal liver metastases using intraoperative ultrasonography. Br J Surg 78:45–48

    Article  PubMed  CAS  Google Scholar 

  • Consensus Conference (1998) Prevention, diagnosis and treatment of colon cancer (French). Gastroenterol Clin Biol 22: 205–218

    Google Scholar 

  • Dalla-Palma L, Bertolottom, Quaia E et al (1999) Detection of liver metastases with pulse inversion harmonic imaging: preliminary results. Euro Radiol 9[Suppl 3]:S382–S387

    Article  Google Scholar 

  • Delpero JR, Pol B, Le Treut P et al (1998) Surgical resection of locally recurrent colorectal adenocarcinoma. Br J Surg 85:372–376

    Article  PubMed  CAS  Google Scholar 

  • De Salvo L, Razzetta F, Arezzo A et al (1997) Surveillance after colorectal cancer surgery. Eur J Surg Oncol 23:522–525

    Article  PubMed  Google Scholar 

  • Dube S, Heyen F, Jenicek M (1997) Adjuvant chemotherapy in colorectal carcinoma: results of a meta-analysis. Dis Colon Rectum 40:35–41

    Article  PubMed  CAS  Google Scholar 

  • Findlay IG, McArdle CS (1986) Occult hepatic metastases in colorectal carcinoma. Br J Surg 73:732–735

    Article  Google Scholar 

  • Finlay IG, Meek D, Brunton F et al (1988) Growth rate of hepatic metastases in colorectal carcinoma. Br J Surg 75: 641–644

    Article  PubMed  CAS  Google Scholar 

  • Floyd EC, Corley RG, Chon J (1965) Local recurrence of carcinoma of the colon and rectum. Am J Surg 109:150–159

    Article  Google Scholar 

  • Fong Y, Fortner J, Sun RL et al (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer analysis of 1001 consecutive cases. Ann Surg 230:309–321

    Article  PubMed  CAS  Google Scholar 

  • Gillams AR, Lees WR (2000) Survival after percutaneous, image-guided, thermal ablation of hepatic metastases from colorectal cancer. Dis Colon Rectum 43:656–661

    Article  PubMed  CAS  Google Scholar 

  • Glover MA, Douse P, Kane P et al (2002) Accuracy of investigations for asymptomatic colorectal liver metastases. Dis Colon Rectum 45:476–484

    Article  PubMed  CAS  Google Scholar 

  • Goldberg PA, Nicholls RJ, Porter NH et al (1994) Long-term results of a randomised trial of short-course low-dose adjuvant pre-operative radiotherapy for rectal cancer: reduction in local treatment failure. Eur J Cancer 30A: 1602–1606

    Article  PubMed  CAS  Google Scholar 

  • Goldberg RM, Fleming TR, Tangen CM et al (1998) Surgery for recurrent colon cancer: strategies for identifying resectable recurrence and success rates after resection. Eastern Cooperative Oncology Group, North Central Cancer Treatment Group, and the Southwest Oncology Group. Ann Intern Med 129:27–35

    PubMed  CAS  Google Scholar 

  • Gore RM (1997) Colorectal cancer clinical and pathologic features. Radiol Clin North Am 35:403–429

    PubMed  CAS  Google Scholar 

  • Guidelines for the Management of Colorectal Cancer (2001) The Association of Coloproctology of Great Britain and Ireland

    Google Scholar 

  • Hamy A, Baron O, Bennouna J et al (2001) Resection of hepatic and pulmonary metastases in patients with colorectal cancer. Am J Clin Oncol 24:607–609

    Article  PubMed  CAS  Google Scholar 

  • Hermanek P, Junginger T, Hossfeld DK et al (1999) Follow-up and rehabilitation for patients with gastrointestinal tumours. Dtsch Arztebl 96a:2084–2088

    Google Scholar 

  • Howell JD, Wotherspoon H, Leen E et al (1999) Evaluation of a follow-up programme after curative resection for colorectal cancer. Br J Cancer 79:308–310

    Article  PubMed  CAS  Google Scholar 

  • Imdahl A, Reinhardt MJ, Nitzsche EU et al (2000) Impact of 18-FDG-positron emission tomography for decision making in colorectal cancer recurrences. Langenbecks Arch Surg 385:129–134

    Article  PubMed  CAS  Google Scholar 

  • Inoue M, Kotake Y, Nakagawa K et al (2000) Surgery for pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 70:380–383

    Article  PubMed  CAS  Google Scholar 

  • International Multicentre Pooled Analysis of B2 Colon Cancer Trials (IMPACT B2) (1999) Efficacy of adjuvant fluorouracil and folinic acid in B2 colon cancer. J Clin Oncol 17: 1356–1363

    Google Scholar 

  • Jaffe BM, Donegan WL, Watson F et al (1968) Factors influencing survival in patients with untreated hepatic metastases. Surg Gynecol Obstet 127:1–11

    PubMed  CAS  Google Scholar 

  • Jeffery GM, Hickey BE, Hider P (2002) Follow-up strategies for patients treated for non-metastatic colorectal cancer (Cochrane Review). Cochrane Library, issue 2, Oxford: Update Software

    Google Scholar 

  • Johnson K, Bakhsh A, Young D et al (2001) Correlating computed tomography and positron emission tomography scan with operative findings in metastatic colorectal cancer. Dis Colon Rectum 44:354–357

    Article  PubMed  CAS  Google Scholar 

  • Kelvin FM, Korobkin M, Heaston DK et al (1983) The pelvis after surgery for rectal carcinoma: serial CT observations with emphasis on nonneoplastic features. AJR Am J Roentgenol 141:959–964

    PubMed  CAS  Google Scholar 

  • Keogan MT, Lowe VJ, Baker ME et al (1997) Local recurrence of rectal cancer: evaluation with F18-fluoredeoxyglucose PET imaging. Abdom Imaging 22:332–337

    Article  PubMed  CAS  Google Scholar 

  • Kievit J (2002) Follow-up of patients with colorectal cancer: numbers needed to test and treat. Eur J Cancer 38:986–999

    Article  PubMed  CAS  Google Scholar 

  • Kinkel K, Lu Y, Both M et al (2002) Detection of hepatic metastases from cancers of the gastrointestinal tract using noninvasive imaging methods (US, CT, MR Imaging, PET): a meta-analysis. Radiology 224:748–756

    Article  PubMed  Google Scholar 

  • Kjeldsen BJ, Kronborg O, Fenger C et al (1997)a A prospective randomized study of follow-up after radical surgery for colorectal cancer. Br Surg 84:666–669

    Article  CAS  Google Scholar 

  • Kjeldsen BJ, Kronborg O, Fenger C et al (1997)b The pattern of recurrent colorectal cancer in a prospective randomised study and the characteristics of diagnostic tests. Int J Colorectal Dis 12:329–334

    Article  PubMed  CAS  Google Scholar 

  • Krestin GP (1997) Is magnetic resonance imaging the method of choice in the diagnosis of recurrent rectal carcinoma? Abdom Imaging 22:343–345

    Article  PubMed  CAS  Google Scholar 

  • Leen E, Angerson WJ, Wotherspoon H et al (1995) Detection of colorectal liver metastases: comparison of laparotomy, CT, US and Doppler perfusion index and evaluation of postoperative follow-up results. Radiology 195:113–116

    PubMed  CAS  Google Scholar 

  • Leveson SH, Wiggins PA, Giles GR et al (1985) Deranged blood flow patterns in the detection of liver metastases. Br J Surg 72:128–130

    Article  PubMed  CAS  Google Scholar 

  • Levi F, Misset JL, Brienza S et al (1992) A chronopharmacologic phase II clinical trial with 5-flurouracil, folinic acid, and oxaliplatin using ambulatory multichannel programmable pump. High antitumor effectiveness against metastatic colorectal cancer. Cancer 69:893–900

    Article  PubMed  CAS  Google Scholar 

  • McAfee MK, Allen MS, Trastek VF et al (1992) Colorectal lung metastases: results of surgical excision. Ann Thorac Surg 53:780–785

    Article  PubMed  CAS  Google Scholar 

  • Mäkelä JT, Laitinen SO, Kairaluoma MI (1995) Five-year follow-up after radical surgery for colorectal cancer. Results of a prospective randomized trial. Arch Surg 130: 1062–1067

    Article  Google Scholar 

  • Markus J, Morrissey B, DeGara C et al (1997) MRI of recurrent rectosigmoid carcinoma. Abdom Imaging 22:338–342

    Article  PubMed  CAS  Google Scholar 

  • Morgan-Parkes JH (1995) Metastases: mechanisms, pathways, and cascades. AJR 164:1075–1082

    PubMed  CAS  Google Scholar 

  • Mossa AR, Ree PC, Marks JE et al (1975) Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum and rectosigmoid. Br J Surg 62:727–730

    Article  Google Scholar 

  • NHS Executive (1997) Guidance on commissioning cancer services. Improving outcomes in colorectal cancer. The research evidence

    Google Scholar 

  • Nordic Gastrointestinal Tumour Adjuvant Therapy Group (1992) Expectancy or primary chemotherapy in patients with advanced asymptomatic colorectal cancer: a randomized trial. J Clin Oncol 10:904–911

    Google Scholar 

  • Northover J (2000) Which type of follow-up? Hepatogastroenterology 47:335–336

    PubMed  CAS  Google Scholar 

  • O’Dwyer PJ, Stevenson JP, Haller DG et al (2001) Follow-up of stage B and C colorectal cancer in the United States and France. Semin Oncol 28[Suppl 1]:45–49

    PubMed  Google Scholar 

  • Ohlsson B, Breland U, Ekberg H et al (1995) Follow-up after curative surgery for colorectal carcinoma. Randomized comparison with no follow-up. Dis Colon Rectum 38: 619–626

    Article  PubMed  CAS  Google Scholar 

  • Parker SI, Tong T, Bolden S et al (1997) Cancer statistics. CA Cancer J Clin 47:5–27

    Article  PubMed  CAS  Google Scholar 

  • Pema PJ, Bennett WF, Bova JG et al (1994) CT vs MRI in diagnosis of recurrent rectosigmoid carcinoma. J Comput Assist Tomogr 18:256–261

    Article  PubMed  CAS  Google Scholar 

  • Petrowsky H, Gonen M, Jarnagin W et al (2002) Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis. Ann Surg 235:863–871

    Article  PubMed  Google Scholar 

  • Pietra N, Sarli L, Costi R et al (1998) Role of follow-up in management of local recurrences of colorectal cancer: a prospective, randomised study. Dis Colon Rectum 41:1127–1133

    Article  PubMed  CAS  Google Scholar 

  • Pihl E, Hughes ES, McDermott FT et al (1981) Disease-free survival and recurrence after resection of colorectal carcinoma. J Surg Oncol 16:333–341

    Article  PubMed  CAS  Google Scholar 

  • Polk HC, Spratt JS (1971) Recurrent colorectal carcinoma. Detection, treatment and other considerations. Surgery 69:9–23

    PubMed  Google Scholar 

  • Quirke P, Durdey P, Dixon MF et al (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection: histological study of lateral tumour spread and surgical excision. Lancet ii:996–999

    Article  Google Scholar 

  • Renehan AG, O’Dwyer ST (2000) Surveillance after colorectal cancer resection. Lancet 355:1095–1096

    Article  PubMed  CAS  Google Scholar 

  • Richert-Boe KE (1995) Heterogeneity of cancer surveillance practices among medical oncologists in Washington and Oregon. Cancer 75:2605–2612

    Article  PubMed  CAS  Google Scholar 

  • Rosen M, Chan L, Beart RW et al (1998) Follow-up of colorectal cancer a meta-analysis. Dis Colon Rectum 41:1116–1126

    Article  PubMed  CAS  Google Scholar 

  • Rougier P, Bugat R, Douillard JY et al (1997) Phase II study of irinotecan in the treatment of advanced colorectal cancer in chemotherapy-naïve patients and patients pretreated with fluorouracil-based chemotherapy. J Clin Oncol 15:251–260

    PubMed  CAS  Google Scholar 

  • Safi F, Link KH, Beger HG (1993) Is follow-up of colorectal cancer patients worthwhile? Dis Colon Rectum 36: 636–644

    Article  PubMed  CAS  Google Scholar 

  • Sarela AI, Guthrie JA, Seymour MT et al (2001) Non-operative management of the primary tumour in patients with incurable stage IV colorectal cancer. Br J Surg 88:1352–1356

    Article  PubMed  CAS  Google Scholar 

  • Schoemaker D, Black R, Giles L et al (1998) Yearly colonoscopy, liver CT, and chest radiography do not influence 5-year survival of colorectal cancer patients. Gastroenterology 114:7–14

    Article  PubMed  CAS  Google Scholar 

  • Scott DJ, Guthrie JA, Arnold P et al (2001) Dual phase helical CT versus portal venous phase CT for the detection of colorectal liver metastases: correlation with intra-operative sonography, surgical and pathological findings. Clin Rad 56:235–242

    Article  CAS  Google Scholar 

  • Secco GB, Fardelli R, Gianquinto D et al (2002) Efficacy and cost of risk — adapted follow-up in patients after colorectal cancer surgery: a prospective, randomised and controlled trial. Eur J Surg Oncol 28:418–423

    Article  PubMed  Google Scholar 

  • Shepherd NA, Quirke P (1997) Colorectal cancer reporting: are we failing the patient? J Clin Pathol 50:266–267

    Article  PubMed  CAS  Google Scholar 

  • Sobin LH, Wittekind C (2002) TNM classification of malignant tumours, 6th edn. Wiley-Liss, New York, pp 72–76

    Google Scholar 

  • Staib L, Link KH, Beger HG (2000) Follow-up in colorectal cancer: cost-effectiveness analysis of established and novel concepts. Langenbecks Arch Surg 385:412–420

    Article  PubMed  CAS  Google Scholar 

  • Stiggelbout AM, de Haes JC, Vree R et al (1997) Follow-up of colorectal cancer patients: quality of life and attitudes towards follow-up. Br J Cancer 75:914–920

    Article  PubMed  CAS  Google Scholar 

  • Sugihara K, Yamamoto J (2000) Surgical treatment of colorectal liver metastases. Ann Chir Gynaecol 89:221–224

    PubMed  CAS  Google Scholar 

  • Swedish Rectal Cancer Group (1997) Improved survival with pre-operative radiotherapy rectal cancer. N Eng J Med 336: 980–987

    Article  Google Scholar 

  • Thompson WM, Halvorsen RA, Foster WL Jr (1986) Preoperative and postoperative CT staging of rectosigmoid carcinoma. Am J Roentgenol 146:703–710

    CAS  Google Scholar 

  • Turk PS, Wanebo HJ (1993) Results of surgical treatment of nonhepatic recurrence of carcinoma. Cancer 71(12 Supply):4267–4277

    Article  PubMed  CAS  Google Scholar 

  • Virgo KS, Vernava AM, Long WE et al (1995) Cost of patient follow-up after potentially curative colorectal cancer treatment. JAMA 273:1837–1841

    Article  PubMed  CAS  Google Scholar 

  • Ward J, Naik KS, Guthrie JA et al (1999) Hepatic lesion detection: comparison of MR imaging after the administration of superparamagnetic iron oxide with dual-phase CT by using alternative-free response receiver operating characteristic analysis. Radiology 210:459–466

    PubMed  CAS  Google Scholar 

  • Weiss L, Grundmann E, Torhorst J et al (1986) Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol 150:195–203

    Article  PubMed  CAS  Google Scholar 

  • Wernecke K, Rummeny EJ, Bongartz G et al (1991) Detection of hepatic masses in patients with carcinoma: comparative sensitivities of sonography, CT and MR imaging. Am J Roentgenol 157:731–739

    CAS  Google Scholar 

  • Zhauang H, Sinha P, Pourdehanad M et al (2000) The role of positron emission tomography with fluorine-18-deoxglu-cose in identifying colorectal cancer metastases to liver. Nuci Med Commun 21:793–798

    Article  Google Scholar 

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Authors and Affiliations

  1. Clinical Radiology, St James’s University Hospital, Beckett Street, Leeds, LS9 7TF, UK

    J. Ashley Guthrie MRCP, FRCR (Consultant Radiologist)

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  1. J. Ashley Guthrie MRCP, FRCR
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  1. Department of Clinical Radiology, St. James’s University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK

    Anthony H. Chapman MD

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© 2004 Springer-Verlag Berlin Heidelberg

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Guthrie, J.A. (2004). Staging and Follow-Up of Colorectal Cancer. In: Chapman, A.H. (eds) Radiology and Imaging of the Colon. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18834-3_12

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  • DOI: https://doi.org/10.1007/978-3-642-18834-3_12

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