Nonphysician Clinicians in the Follow-Up of Resected Patients with Colorectal Cancer
Background/Aims: The 5-year postoperative follow-up for patients undergoing curative treatment for colorectal cancer (CRC) is labour intensive. We assessed the added value of a dedicated nonphysician clinician (NPC) in the follow-up of patients after resection for CRC. Methods: Patients were divided into 2 groups as defined by the number of follow-up visits in the first year, including intensive (≥3×) and minimal (≤2×). Involvement of an NPC, diagnosis of disease recurrence and the course of the disease were determined. Results: Of the 681 patients, 79.9% belonged to the “intensive” and 21.1% to the “minimal” group. Involvement of an NPC resulted in a higher adherence to follow-up (84.3 vs. 73.9%, p = 0.001). Overall, patients in regular follow-up less often had multifocal recurrence (47.1 vs. 73.7%, p = 0.04), and a better survival after recurrence (SAR; hazard ratio [HR] 3.604, p < 0.001). The “intensive” group had a significantly better overall survival compared to the “minimal” group (HR 1.71, p = 0.013). Conclusion: Adherence to surveillance programs after resection for CRC is better in hospitals with a dedicated NPC. Overall, patients' adherence to follow-up resulted in less multifocal disease recurrence at the time of diagnosis as compared to patients presenting with symptoms and a better 3-year SAR.
|Keywords||Colorectal cancer, Follow-up, Nonphysician clinicians, Survival analysis|
|Persistent URL||dx.doi.org/10.1159/000478848, hdl.handle.net/1765/102277|
|Journal||Digestive Diseases: clinical reviews|
Coebergh van den Braak, R.R.J, Lalmahomed, Z.S, Büttner, S, Hansen, B.E. (Bettina E.), & IJzermans, J.N.M. (2017). Nonphysician Clinicians in the Follow-Up of Resected Patients with Colorectal Cancer. Digestive Diseases: clinical reviews, 17–25. doi:10.1159/000478848