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Purpose <p>The incidence of colorectal cancer (CRC) is increasing in individuals aged &lt; 50&#xa0;years of age. This study aimed to examine whether high-frequency follow-up after CRC surgery reduces 5-year overall mortality, cancer-specific mortality and recurrence in patients with CRC aged ≤ 50&#xa0;years.</p> Methods <p>The COLOFOL trial performed between 2006 and 2010 was used to analyse patients randomised to high-frequency (computed tomography [CT]&#xa0;of the abdomen and thorax and a carcinoembryonic antigen [CEA] test at 6, 12, 18, 24 and 36&#xa0;months) versus low-frequency (CT and CEA at 12 and 36&#xa0;months) follow-up after curative CRC surgery. Intention-to-treat and per-protocol analyses were performed to study the primary outcomes (5-year overall mortality and cancer-specific mortality) and the secondary outcome (CRC recurrence), comparing the age groups ≤ 50, 51–70 and &gt; 70&#xa0;years.</p> Results <p>In total, 2,509 patients were included in the intention-to-treat analysis with 183, 1,714 and 612 patients aged ≤ 50, 51–70 and &gt; 70&#xa0;years, respectively. The 5-year overall mortality risk for patients aged ≤ 50 was 8.3% in the high-frequency group compared with 8.4% in the low-frequency group (risk difference 0.2% [95% CI, − 8.0; 8.3]). The cancer-specific mortality risk for patients aged ≤ 50&#xa0;years was 7.1% in the high-frequency group compared with 7.4% in the low-frequency group (risk difference, 0.3% [95% CI, − 7.4; 8.0]). The cancer-specific recurrence risk for patients aged ≤ 50&#xa0;years was 12.9% in the high-frequency group compared with 21.0% in the low-frequency group (risk difference 8.1% [95% CI, − 2.6; 18.7]).</p> Conclusion <p>Among individuals aged ≤ 50&#xa0;years with stage II-III CRC, there was no reduction in overall mortality, cancer-specific mortality and cancer-specific recurrence with more intensive follow-up using CT and CEA.</p>

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Follow-up intensity after colorectal cancer surgery in patients aged ≤ 50, 50–70 and > 70 years – an analysis within the COLOFOL randomised clinical trial

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  • 发表日期：

    2026年1月26日

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  • Ida Gutlic,
  • Katalin Veres,
  • Erzsébet Horváth-Puhó,
  • Marie-Louise Lydrup,
  • Pamela Buchwald,
  • Peer Wille-Jørgensen,
  • Sören Laurberg,
  • Lars Påhlman,
  • Andrew Renehan,
  • Kennet Smedh,
  • Ingvar Syk,
  • Henrik Toft Sørensen,
  • Henrik Christensen,
  • Per Gandrup,
  • Allan Gorm Pedersen,
  • Per Jess,
  • Mogens Rørbæk Madsen,
  • Per Vadgaard Andersen,
  • Peer Wille-Jørgensen,
  • Erling Østergaard,
  • Jonas Bengtsson,
  • Mats Bragmark,
  • Joakim Folkesson,
  • Michael Goldinger,
  • Pernilla Hansdotter Andersson,
  • Rolf Heuman,
  • Kenneth Lindberg,
  • Anna Martling,
  • Michael Dahlberg,
  • Johan Ottosson,
  • Birger Sandzén,
  • Monika Egenvall,
  • Kennet Smedh,
  • Parastau Farahnak,
  • Carlos Barberousse

摘要

Purpose

The incidence of colorectal cancer (CRC) is increasing in individuals aged < 50 years of age. This study aimed to examine whether high-frequency follow-up after CRC surgery reduces 5-year overall mortality, cancer-specific mortality and recurrence in patients with CRC aged ≤ 50 years.

Methods

The COLOFOL trial performed between 2006 and 2010 was used to analyse patients randomised to high-frequency (computed tomography [CT] of the abdomen and thorax and a carcinoembryonic antigen [CEA] test at 6, 12, 18, 24 and 36 months) versus low-frequency (CT and CEA at 12 and 36 months) follow-up after curative CRC surgery. Intention-to-treat and per-protocol analyses were performed to study the primary outcomes (5-year overall mortality and cancer-specific mortality) and the secondary outcome (CRC recurrence), comparing the age groups ≤ 50, 51–70 and > 70 years.

Results

In total, 2,509 patients were included in the intention-to-treat analysis with 183, 1,714 and 612 patients aged ≤ 50, 51–70 and > 70 years, respectively. The 5-year overall mortality risk for patients aged ≤ 50 was 8.3% in the high-frequency group compared with 8.4% in the low-frequency group (risk difference 0.2% [95% CI, − 8.0; 8.3]). The cancer-specific mortality risk for patients aged ≤ 50 years was 7.1% in the high-frequency group compared with 7.4% in the low-frequency group (risk difference, 0.3% [95% CI, − 7.4; 8.0]). The cancer-specific recurrence risk for patients aged ≤ 50 years was 12.9% in the high-frequency group compared with 21.0% in the low-frequency group (risk difference 8.1% [95% CI, − 2.6; 18.7]).

Conclusion

Among individuals aged ≤ 50 years with stage II-III CRC, there was no reduction in overall mortality, cancer-specific mortality and cancer-specific recurrence with more intensive follow-up using CT and CEA.