Improved outcome in asymptomatic recurrence following curative surgery for gastric cancer.
The purpose of this study was to compare the outcome and resectability of patients with gastric cancer recurrence after curative surgery detected by follow-up endoscopy, according to the presence or absence of symptoms. All patients with gastric carcinoma, who underwent a curative gastrectomy, were retrospectively identified. We analyzed outcome and survival in patients compliant with routine follow-up who presented symptomatic and asymptomatic recurrence. Of the 119 resected patients, 63.0% had a recurrence, with an overall survival of 20.0 months. Fourteen patients were asymptomatic when recurrence was detected, whereas 61 patients were symptomatic. Median time to recurrence was 16.0 m for both groups. A local curative re-resection was possible in 2/14 (asymptomatic) and 1/61 (symptomatic). Asymptomatic patients had a longer median postrecurrence survival time of 9.0 months, compared with 2.0 months in the symptomatic patients (p=0.034). The median overall survival was greater in the asymptomatic vs symptomatic group (25.0 vs 20.0 months), although this did not reach statistical significance. The results from this study advocate that the presence or absence of symptoms is a good surrogate marker to assess biologic aggressiveness. The value of routine follow-up endoscopy to permit a higher rate of re-resection in asymptomatic patients remains to be established.
Department of Medical Oncology and Hematology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran (INCMNSZ), Vasco de Quiroga 15, Seccion XVI. Del. Tlalpan, C.P. 14000, Mexico City, DF, Mexico. cynthiavg@gmail.com
Cynthia
C
Villarreal-Garza
Miriam
M
Rojas-Flores
Andrea
A
Castro-Sánchez
Antonio R
AR
Villa
Luis
L
García-Aceituno
Eucario
E
León-Rodríguez
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome