Value of intensive follow-up of patients after curative surgery for gastric carcinoma.
OBJECTIVE
Most clinicians perform surveillance after gastrectomy for gastric cancer. There is no consensus on the regimen, follow-up interval and choice of investigations. This study aims to review the long-term results of patients followed-up in our institution after gastrectomy for gastric cancer.


METHODS
Patients with gastric carcinoma who had undergone gastrectomy between 1995 and 1998 were reviewed. The patients were assigned to either intensive or regular regimen based on the follow-up they had undergone. Intensive regimen included routine physical examination, serum tumor markers, and the use of computed tomography (CT) scan of more than once per year in the follow-up.


RESULTS
A total of 102 patients were reviewed. Forty-nine patients received intensive and 53 patients received regular follow-up. Recurrences were detected earlier in the intensive group (11.5 vs. 19.2 months, P = 0.02). There was no difference in the length of survival in the two groups. Most recurrences (60%) were detected by CT scan.


CONCLUSIONS
Intensive follow-up after gastrectomy resulted in the earlier detection of recurrences. However, there was no survival benefit from this regimen. A regimen based on symptoms and physical examination is adequate for most patients. CT was the most useful investigation for detection of recurrences.
Department of Surgery, National University Hospital, Singapore, Republic of Singapore. ingtuan@yahoo.com
Ing Tuan
IT
Tan
Bok Yan Jimmy
BY
So
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed