Benefit of post-operative surveillance for recurrence after curative resection for gastric cancer.
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.
Kim
Jong-Han
JH
Department of Surgery, Korea University College of Medicine, 5-ga, Anam-dong, Sungbuk-gu, Seoul 136-701, South Korea.
Jang
You-Jin
YJ
Park
Sung-Soo
SS
Park
Seong-Heum
SH
Mok
Young-Jae
YJ
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
Ann Oncol. 1997 Feb;8(2):163-8
9093725
BMJ. 2002 Apr 6;324(7341):813
11934773
Ann Surg Oncol. 2008 Jun;15(6):1632-9
18379851
Ann Surg Oncol. 2010 Feb;17(2):448-54
19904573
JAMA. 1994 May 25;271(20):1593-7
7848404
Gastric Cancer. 2006;9(2):74-81
16767361
Ann Surg. 2002 Jun;235(6):759-66
12035031
J Clin Oncol. 1997 Aug;15(8):2996-3018
9256144
Br J Cancer. 1995 Mar;71(3):587-91
7533517
J Am Coll Surg. 2005 Oct;201(4):503-10
16183487
J Clin Oncol. 1999 Apr;17(4):1312
10561194
J Clin Oncol. 1999 Mar;17(3):1080-2
10071303
Dis Colon Rectum. 1998 Sep;41(9):1127-33
9749496
Ann Surg Oncol. 2003 Oct;10(8):898-902
14527908
Ann Surg. 2000 Apr;231(4):487-99
10749608
Br J Surg. 2000 Feb;87(2):236-42
10671934
Hepatogastroenterology. 2000 Sep-Oct;47(35):1489-94
11100384
J Surg Oncol. 2007 Nov 1;96(6):503-6
17680634
BMC Cancer. 2009 Mar 01;9:73
19250554
J Surg Oncol. 1995 Nov;60(3):174-9
7475067
Hepatogastroenterology. 2002 Jul-Aug;49(46):1062-5
12143202