Nisenboym Michal1, Kopelman Doron2*, Shulman Katerina3 and Kopelman Yael1
1Department of Gastroenterology, Hillel-Yaffe Medical Center, Israel
2Department of General Surgery, Haemek Medical Center, Israel
3Department of Oncology, Hillel-Yaffe Medical Center, Israel
Aim: To determine the optimal time to first surveillance, to evaluate potential risk factors.
Background: Endoscopic Surveillance after Colorectal Cancer (CRC) resection enables early detection of recurrence and prophylactic resection of polyps. There is no agreement regarding the timing of first colonoscopy after CRC resection.
Methods: A retrospective data analysis of 246 CRC patients who underwent curative surgical resection between 2007 to 2013, and had at least one postoperative colonoscopy conducted up to 3 years from surgery. Demographic, disease and endoscopic-associated variables were recorded.
Results: The prevalence of pathological findings was higher among patients performing late (18 to 36 months) surveillance colonoscopy (39.6%) compared to the early (up to 18 months) surveillance group (21.5%) (p<0.005). The Receiver Operator Characteristic (ROC) analysis revealed optimal cut-off time for postoperative first surveillance colonoscopy at 17.5 months. Patients who had pathological findings were older at diagnosis compared to disease-free patients.
Conclusion: Older age and higher grade at presentation are risk factors for the presence of pathological findings on first surveillance colonoscopy. A relation between time to first surveillance colonoscopy and presence of pathological findings has been markedly highlighted. First surveillance colonoscopy was found to be optimal at 17.5 months post operation. The need to agreed guidelines is eminent.
Michal N, Doron K, Katerina S, Yael K. Timing of First Surveillance Colonoscopy after Curative Resection of Colorectal Cancer. Clin Surg. 2019; 4: 2453.