Follow-Up Surveillance for Recurrence After Curative Gastric Cancer Surgery Lacks Survival Benefit
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Background: Although routine follow-up to detect asymptomatic recurrence after surgery for gastric cancer is recommended, the effect of such reassessment on survival has not been evaluated.
Methods: Clinical records of patients developing recurrent disease after potentially curative resection between 1985 and 1996 were retrieved. Among these patients, 197 were in our follow-up program. We analyzed survival in these patients according to the presence or absence of cancer-related symptoms when recurrent disease was diagnosed.
Results: Of all patients with recurrent disease, 50% were diagnosed within 1 year and 75% within 2 years of surgery. Asymptomatic recurrence, detected in 88 patients (45%), frequently represented distant metastasis. Although early detection significantly improved survival after detection of recurrent disease, disease-free survival for this subset was shorter. Thus, no significant difference in overall survival was observed.
Conclusions: Early detection of asymptomatic gastric cancer recurrence did not improve overall survival of patients with recurrence after curative resection. Until development of more effective treatment for this disease, close follow-up may offer no survival benefit.
Key WordsCancer recurrence Follow-up Gastrectomy Curative resection Gastric carcinoma
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- 1.Gunderson LL, Donohue JH, Burch PA. Stomach Abeloff MD, Armitage JO, Lichter AS Eds. Clinical Oncology. New York:: Churchill Livingstone, 1995: 1209–41.Google Scholar
- 2.Boehner H, Zimmer T, Hopfenmueller W, Berger G, Buhr HJ. Detection and prognosis of recurrent gastric cancer—is routine follow-up after gastrectomy worthwhile? Hepatogastroenterology 2000;47:1489–94.Google Scholar
- 3.NCCN practice guidelines for upper gastrointestinal carcinomas. National Comprehensive Cancer Network. Oncology (Huntingt) 1998;12:179–223.Google Scholar
- 4.Sobin, LHWittekind, C eds. 1997TNM Classification of Malignant Tumours5th ed.WileyNew YorkGoogle Scholar