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Background <p>There is no significant difference in postoperative follow-up imaging examinations for varying mismatch repair (MMR)/microsatellite instability (MSI) statuses for sporadic colorectal cancer while facing different prognoses.</p> Methods <p>We conducted a retrospective study, using Kaplan-Meier curve to compare survival/progression status by varying imaging examination and frequency, using Cox regression to analyze tumor characteristic impact on survival, and monitoring polyp detection time in each colonoscopy screening.</p> Results <p>A total of 282 deficient MMR (dMMR)/MSI-high (MSI-H) patients were included. After a 7&#xa0;year follow-up, all patients—including 143 examined by CT and colonoscopy, 86 singularly examined (CT/colonoscopy/ultrasound), and 53 received no imaging examination—demonstrated a favorable overall survival (87.97%, 95% CI 75.99–89.19) and disease-free survival (81.92%, 95% CI 70.38–89.30), which had no significant difference between imaging methods. Cox regression proved that different imaging methods had no influence on the prognosis. Stage III patients experienced a deterioration in disease-free survival but not differed between varying imaging methods. Different CT follow-up interval exhibited no difference in survival and progression. Polyps were detected in 39.75% (64/161) of patients during follow-up; 32.81% (21/64) were detected in colonoscopy conducted 0–6&#xa0;months after surgery, reaching the highest. For multiple polyps, the median of detection interval was 13–24&#xa0;months (first and second polyps), 7–12&#xa0;months (second and third polyps).</p> Conclusions <p>For nonmetastatic dMMR/MSI-H sporadic colorectal cancer patients, less CT scans (interval &gt; 1&#xa0;year) are tolerable because of good prognosis, whereas more colonoscopy screenings (0–6&#xa0;months after surgery first year; 13–24&#xa0;months after first polyps detection; 7–12&#xa0;months after second polyps detection) is considerable.</p>

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Decreasing Use of CT in Favor of Colonoscopy: A Retrospective Analysis of Post-Operative Imaging in Nonmetastatic dMMR/MSI-H Sporadic Colorectal Cancer

  • 期刊论文

  • 发表日期：

    2025年2月13日

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  • Si-yuan Mi,
  • Yi-jun Liao,
  • Da Kang,
  • Xin Tang,
  • Gong Chen,
  • Zhi-zhong Pan,
  • Jianhua Zhan,
  • Rong-xin Zhang

摘要

Background

There is no significant difference in postoperative follow-up imaging examinations for varying mismatch repair (MMR)/microsatellite instability (MSI) statuses for sporadic colorectal cancer while facing different prognoses.

Methods

We conducted a retrospective study, using Kaplan-Meier curve to compare survival/progression status by varying imaging examination and frequency, using Cox regression to analyze tumor characteristic impact on survival, and monitoring polyp detection time in each colonoscopy screening.

Results

A total of 282 deficient MMR (dMMR)/MSI-high (MSI-H) patients were included. After a 7 year follow-up, all patients—including 143 examined by CT and colonoscopy, 86 singularly examined (CT/colonoscopy/ultrasound), and 53 received no imaging examination—demonstrated a favorable overall survival (87.97%, 95% CI 75.99–89.19) and disease-free survival (81.92%, 95% CI 70.38–89.30), which had no significant difference between imaging methods. Cox regression proved that different imaging methods had no influence on the prognosis. Stage III patients experienced a deterioration in disease-free survival but not differed between varying imaging methods. Different CT follow-up interval exhibited no difference in survival and progression. Polyps were detected in 39.75% (64/161) of patients during follow-up; 32.81% (21/64) were detected in colonoscopy conducted 0–6 months after surgery, reaching the highest. For multiple polyps, the median of detection interval was 13–24 months (first and second polyps), 7–12 months (second and third polyps).

Conclusions

For nonmetastatic dMMR/MSI-H sporadic colorectal cancer patients, less CT scans (interval > 1 year) are tolerable because of good prognosis, whereas more colonoscopy screenings (0–6 months after surgery first year; 13–24 months after first polyps detection; 7–12 months after second polyps detection) is considerable.