Colorectal follow-up planning modified on the basis of our personal experience.

Background: The authors, evaluating the disappointing follow-up results in patients suffering from colorectal carcinoma who had undergone surgery for cure, tried a more rational follow-up. Methods: In a retrospective review about 232 patients who adhered to the follow-up protocol, we evaluated the accuracy rates of CEA, liver ultrasonography and abdominal CT. In the same group of patients, we evaluated the type of correlation between the neoplastic recurrence rate and Astler-Coller's classification. Results: (1) In detecting hepatic metastases CEA levels furnished sensitivity and negative predictive value more than liver ultrasonography (83.3 vs. 77.8% and 98.4 vs. 98%, respectively); (2) in our series, we obtained a lower recurrence rate in classes A+B1 (7.5%) and B2 (20.8%) and higher in C1+C2 (44.4%) and D (66.7%) (p<0.01). Conclusion: According to these data we decided to eliminate postoperative liver ultrasonography and customize follow-up protocol on tumor staging and timing of cancer relapse. The authors believe that these changes will not modify-the results, but cause less psychophysical stress for the patients and reduce costs by 50%.