title: Follow-up surveillance for recurrence after curative gastric cancer surgery lacks survival benefit.
abstract: 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.
authors.affiliation: Department of Surgery II, Nagoya University School of Medicine, Aichi, Japan. ykodera@med.nagoya-u.ac.jp
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kodera
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamamura
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Mochizuki
authors.forename: Michitaka
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Kenji
authors.initials: K
authors.lastname: Hibi
authors.forename: Katsuki
authors.initials: K
authors.lastname: Ito
authors.forename: Seiji
authors.initials: S
authors.lastname: Akiyama
authors.forename: Akimasa
authors.initials: A
authors.lastname: Nakao
mesh_terms: D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011159:Population Surveillance; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis