title: Benefit of post-operative surveillance for recurrence after curative resection for gastric cancer.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Korea University College of Medicine, 5-ga, Anam-dong, Sungbuk-gu, Seoul 136-701, South Korea.
authors.forename: Jong-Han
authors.initials: JH
authors.lastname: Kim
authors.forename: You-Jin
authors.initials: YJ
authors.lastname: Jang
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Park
authors.forename: Seong-Heum
authors.initials: SH
authors.lastname: Park
authors.forename: Young-Jae
authors.initials: YJ
authors.lastname: Mok
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000601:surgery; D016019:Survival Analysis
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