How tumor stage affects surgeons' surveillance strategies after colon cancer surgery

Abstract

The factors that influence decision making among surgeons are not well understood. This study sought to evaluate how the tumor stage of patients subjected to potentially curative surgery for colon cancer affects the follow-up strategies used by practicing surgeons. Hypothetical patient profiles and a detailed questionnaire based on these profiles were mailed to 2733 members of two major surgical societies. The effect of TNM Stage on the surveillance strategies chosen by the respondents was analyzed. Seven of the nine most commonly used surveillance modalities all were performed significantly more frequently with increasing TNM Stage. This effect persisted through 5 years of follow-up. The other two modalities (computed tomography and bone scan) were performed too infrequently for meaningful analysis. Surgeons performing surveillance after potentially curative surgery for otherwise healthy patients with colon cancer modify their strategies according to the patient's TNM Stage. These data should help in the design of prospective trials related to this topic.