Skip to main content
Log in

Benefit of Post-operative Surveillance for Recurrence after Curative Resection for Gastric Cancer

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Although most clinicians perform surveillance after gastrectomy, there is no consensus on the optimal follow-up schedule. This study aimed to evaluate the benefit of postoperative surveillance for recurrence after curative resection for gastric cancer.

Method

We retrospectively studied 110 patients who had recurrences after undergoing curative gastrectomies between 2000 and 2004 at Korea University Hospital. We analyzed the clinico-pathologic factors and oncologic results according to the presence of recurrence symptoms.

Results

Fifty-five (50%) patients had symptomatic recurrences. There were significant differences in recurrence patterns; locoregional (29.1%) and peritoneal recurrences (27.3%) were dominant in asymptomatic group; peritoneal (47.3%) and hematogenous recurrences (25.5%) were dominant in symptomatic group. The median recurrence-free survival was not different for both groups (p = 0.054). However, median overall and post-recurrence survival was poor in the symptomatic group (p = 0.004, p < 0.001). The presence of symptoms and short disease-free survival were independent poor prognostic factors for post-recurrence survival.

Conclusion

Patients with asymptomatic recurrences could have increased survival compared to symptomatic patients. Although our post-operative surveillance could not be any benefit to improve outcomes for recurrent gastric cancer, it is important to discriminate the nature of recurrent gastric cancer by the presence of symptoms for planning further treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. National Comprehensive Cancer Network (U.S.). The complete library of NCCN clinical practice guidelines in oncology. Rockledge, PA: National Comprehensive Cancer Network; 2003. p 1 computer optical disc.

  2. Whiting J, Sano T, Saka M, Fukagawa T, Katai H, Sasako M. Follow-up of gastric cancer: a review. Gastric Cancer 2006;9:74-81.

    Article  PubMed  Google Scholar 

  3. Pietra N, Sarli L, Costi R, Ouchemi C, Grattarola M, Peracchia A. Role of follow-up in management of local recurrences of colorectal cancer: a prospective, randomized study. Dis Colon Rectum 1998;41:1127–1133.

    Article  CAS  PubMed  Google Scholar 

  4. Johnson FE, Virgo KS. Cancer patient follow-up. St. Louis: Mosby; 1997.

    Google Scholar 

  5. Renehan AG, Egger M, Saunders MP, O'Dwyer ST. Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. BMJ 2002;324:813.

    Article  PubMed  Google Scholar 

  6. Desch CE, Benson AB, 3rd, Smith TJ, Flynn PJ, Krause C, Loprinzi CL, Minsky BD, Petrelli NJ, Pfister DG, Somerfield MR. Recommended colorectal cancer surveillance guidelines by the American Society of Clinical Oncology. J Clin Oncol 1999;17:1312.

    CAS  PubMed  Google Scholar 

  7. Rosselli Del Turco M, Palli D, Cariddi A, Ciatto S, Pacini P, Distante V. Intensive diagnostic follow-up after treatment of primary breast cancer. A randomized trial. National Research Council Project on Breast Cancer follow-up. JAMA 1994;271:1593–1597.

    Article  CAS  PubMed  Google Scholar 

  8. Smith TJ, Davidson NE, Schapira DV, Grunfeld E, Muss HB, Vogel VG, 3rd, Somerfield MR. American Society of Clinical Oncology 1998 update of recommended breast cancer surveillance guidelines. J Clin Oncol 1999;17:1080–1082.

    CAS  PubMed  Google Scholar 

  9. Clinical practice guidelines for the treatment of unresectable non-small-cell lung cancer. Adopted on May 16, 1997 by the American Society of Clinical Oncology. J Clin Oncol 1997;15:2996–3018.

  10. Kodera Y, Ito S, Yamamura Y, Mochizuki Y, Fujiwara M, Hibi K, Ito K, Akiyama S, Nakao A. Follow-up surveillance for recurrence after curative gastric cancer surgery lacks survival benefit. Ann Surg Oncol 2003;10:898–902.

    Article  PubMed  Google Scholar 

  11. Tan IT, So BY. Value of intensive follow-up of patients after curative surgery for gastric carcinoma. J Surg Oncol 2007;96:503–506.

    Article  PubMed  Google Scholar 

  12. Bohner H, Zimmer T, Hopfenmuller W, Berger G, Buhr HJ. Detection and prognosis of recurrent gastric cancer—is routine follow-up after gastrectomy worthwhile? Hepatogastroenterology 2000;47:1489–1494.

    CAS  PubMed  Google Scholar 

  13. Bennett JJ, Gonen M, D'Angelica M, Jaques DP, Brennan MF, Coit DG. Is detection of asymptomatic recurrence after curative resection associated with improved survival in patients with gastric cancer? J Am Coll Surg 2005;201:503–510.

    Article  PubMed  Google Scholar 

  14. Lacueva FJ, Calpena R, Medrano J, Compan AF, Andrada E, Molto M, Ferrer R, Diego M. Follow-up of patients resected for gastric cancer. J Surg Oncol 1995;60:174–179.

    Article  CAS  PubMed  Google Scholar 

  15. Yoo CH, Noh SH, Shin DW, Choi SH, Min JS. Recurrence following curative resection for gastric carcinoma. Br J Surg 2000;87:236–242.

    Article  CAS  PubMed  Google Scholar 

  16. Sobin LH, Wittekind C, International Union against Cancer. TNM:classification of malignant tumours. 5th ed. New York: Wiley, 1997.

  17. Youn HG, An JY, Choi MG, Noh JH, Sohn TS, Kim S. Recurrence after curative resection of early gastric cancer. Ann Surg Oncol 2009.

  18. Sim SH, Kim YJ, Oh DY, Lee SH, Kim DW, Kang WJ, Im SA, Kim TY, Kim WH, Heo DS, Bang YJ. The role of PET/CT in detection of gastric cancer recurrence. BMC Cancer 2009;9:73.

    Article  PubMed  Google Scholar 

  19. Ahn HS, Kim JW, Yoo MW, Park do J, Lee HJ, Lee KU, Yang HK. Clinicopathological features and surgical outcomes of patients with remnant gastric cancer after a distal gastrectomy. Ann Surg Oncol 2008;15:1632–639.

    Article  PubMed  Google Scholar 

  20. Choti MA, Sitzmann JV, Tiburi MF, Sumetchotimetha W, Rangsin R, Schulick RD, Lillemoe KD, Yeo CJ, Cameron JL. Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg 2002;235:759–766.

    Article  PubMed  Google Scholar 

  21. Minagawa M, Makuuchi M, Torzilli G, Takayama T, Kawasaki S, Kosuge T, Yamamoto J, Imamura H. Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results. Ann Surg 2000;231:487–499.

    Article  CAS  PubMed  Google Scholar 

  22. Saiura A, Umekita N, Inoue S, Maeshiro T, Miyamoto S, Matsui Y, Asakage M, Kitamura M. Clinicopathological features and outcome of hepatic resection for liver metastasis from gastric cancer. Hepatogastroenterology 2002;49:1062–1065.

    PubMed  Google Scholar 

  23. Glimelius B, Ekstrom K, Hoffman K, Graf W, Sjoden PO, Haglund U, Svensson C, Enander LK, Linne T, Sellstrom H, Heuman R. Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 1997;8:163–168.

    Article  CAS  PubMed  Google Scholar 

  24. Pyrhonen S, Kuitunen T, Nyandoto P, Kouri M. Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. Br J Cancer 1995;71:587–591.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Young-Jae Mok.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, JH., Jang, YJ., Park, SS. et al. Benefit of Post-operative Surveillance for Recurrence after Curative Resection for Gastric Cancer. J Gastrointest Surg 14, 969–976 (2010). https://doi.org/10.1007/s11605-010-1200-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-010-1200-4

Keywords

Navigation