Who should manage post-treatment care for patients with colon cancer: surgeons or general practitioners?

Abstract

In The Lancet Oncology, Julien A M Vos and colleagues 1 Vos JAM Duineveld LAM Wieldraaijer T et al. Effect of general practitioner-led versus surgeon-led colon cancer survivorship care, with or without eHealth support, on quality of life (I CARE): an interim analysis of 1-year results of a randomised, controlled trial. Lancet Oncol. 2021; (published online July 2.)https://doi.org/10.1016/S1470-2045(21)00273-4 Summary Full Text Full Text PDF Scopus (3) Google Scholar have tried to answer an important question with the I CARE study: who should oversee follow-up care for patients with colon cancer? Follow-up after colorectal cancer treatment has previously been studied in several randomised clinical trials, with the aim of providing an evidence base for a follow-up algorithm. 2 Jeffery M Hickey BE Hider PN Follow-up strategies for patients treated for non-metastatic colorectal cancer. Cochrane Database Syst Rev. 2019; 9CD002200 PubMed Google Scholar However, the primary endpoints of these trials was often detection of recurrence or survival. So far, no study or meta-analysis has provided solid evidence that more intense hospital-based follow-up is beneficial for overall survival; other outcomes that follow-up could affect, such as quality of life (QOL), have also not been thoroughly investigated. QOL was the primary endpoint of Vos and colleagues' randomised controlled trial, and thus their approach is novel. The authors have reported interim 1-year QOL results from their 5-year study that compared GP-led follow-up with standard surgeon-led follow-up for patients with colon cancer. No difference in quality of life was apparent between patients who received GP-led follow-up and those who received surgen-led follow-up. Effect of general practitioner-led versus surgeon-led colon cancer survivorship care, with or without eHealth support, on quality of life (I CARE): an interim analysis of 1-year results of a randomised, controlled trialIn terms of QOL, GP-led survivorship care can be considered as an alternative to surgeon-led care within the first year after colon cancer treatment. Other outcomes, including patient and physician preferences, will be important for decisions about the type of survivorship care. Full-Text PDF