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Vos, Julien A M; Sert, Edanur; Busschers, Wim B; Duineveld, Laura A M; Wieldraaijer, Thijs; Wind, Jan; Donkervoort, Sandra C; Govaert, Marc J P M; Beverdam, Frédérique H; Smits, Anke B; Bemelman, Willem A; Heuff, Gijsbert; van Weert, Henk C P M; van Asselt, Kristel M; van Geloven, A A W; van de Ven, A W H

Detection of colon cancer recurrences during follow-up care by general practitioners vs surgeons

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  • Medientyp: E-Artikel
  • Titel: Detection of colon cancer recurrences during follow-up care by general practitioners vs surgeons
  • Beteiligte: Vos, Julien A M; Sert, Edanur; Busschers, Wim B; Duineveld, Laura A M; Wieldraaijer, Thijs; Wind, Jan; Donkervoort, Sandra C; Govaert, Marc J P M; Beverdam, Frédérique H; Smits, Anke B; Bemelman, Willem A; Heuff, Gijsbert; van Weert, Henk C P M; van Asselt, Kristel M; van Geloven, A A W; van de Ven, A W H
  • Erschienen: Oxford University Press (OUP), 2023
  • Erschienen in: JNCI: Journal of the National Cancer Institute
  • Sprache: Englisch
  • DOI: 10.1093/jnci/djad019
  • ISSN: 0027-8874; 1460-2105
  • Schlagwörter: Cancer Research ; Oncology
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>In the I CARE study, colon cancer patients were randomly assigned to receive follow-up care from either a general practitioner (GP) or a surgeon. Here, we address a secondary outcome, namely, detection of recurrences and effect on time to detection of transferring care from surgeon to GP.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Pattern, stage, and treatment of recurrences were described after 3 years. Time to event was defined as date of surgery, until date of recurrence or last follow-up, with death as competing event. Effects on time to recurrence and death were estimated as hazard ratios (HRs) using Cox regression. Restricted mean survival times were estimated.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of 303 patients, 141 were randomly assigned to the GP and 162 to the surgeon. Patients were male (67%) with a mean age of 68.0 (8.4) years. During follow-up, 46 recurrences were detected; 18 (13%) in the GP vs 28 (17%) in the surgeon group. Most recurrences were detected via abnormal follow-up tests (74%) and treated with curative intent (59%). Hazard ratio for recurrence was 0.75 (95% confidence interval [CI] = 0.41 to 1.36) in GP vs surgeon group. Patients in the GP group remained in the disease-free state slightly longer (2.76 vs 2.71 years). Of the patients, 38 died during follow-up; 15 (11%) in the GP vs 23 (14%) in the surgeon group. Of these, 21 (55%) deaths were related to colon cancer. There were no differences in overall deaths between the groups (HR = 0.76, 95% CI = 0.39 to 1.46).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Follow-up provided by GPs vs surgeons leads to similar detection of recurrences. Also, no differences in mortality were found.</jats:p> </jats:sec>
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