title: A systematic review of patient surveillance after curative gastrectomy for gastric cancer: a brief review.
abstract: BACKGROUND
  Complete resection of a gastric cancer and adjacent lymph nodes offers the only chance for cure of the disease. However, disease recurrence occurs in 22-51% of cases, and its prognosis is very poor. Many clinicians perform post-operative follow-up for these patients, although there is no consensus on the regimen, frequency of visits, mode of testing, or the rationale of a follow-up program.
  
  
  OBJECTIVE
  The objective of this systematic review was to identify the evidence for surveillance in patients with resected gastric cancer, specifically examining the interval of follow-up and the modalities utilized.
  
  
  METHODS
  Electronic literature searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from January 1st 1998 to December 1st 2009. All search titles and abstracts were independently rated for relevance by a minimum of two reviewers.
  
  
  RESULTS
  Five articles were selected. A total of 810 patients underwent post-operative follow-up. History and physical examination, hematological and chemistry profile, endoscopy (esophagogastroduodenoscopy [EGD]), and computed tomography (CT) were the most frequently employed modalities. CT detected the majority of recurrences in the included studies. The survival post-recurrence was significantly higher in the asymptomatic group compared with symptomatic group in three studies, but this may simply reflect lead-time bias. No differences in overall survival (OS) were found.
  
  
  CONCLUSIONS
  The included studies failed to show an improvement in OS with more intense surveillance. Further prospective studies are required to determine whether a subgroup of patients may benefit from more intensive follow-up.
authors.affiliation: Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Roberta
authors.initials: R
authors.lastname: Cardoso
authors.forename: Natalie G
authors.initials: NG
authors.lastname: Coburn
authors.forename: Rajini
authors.initials: R
authors.lastname: Seevaratnam
authors.forename: Alyson
authors.initials: A
authors.lastname: Mahar
authors.forename: Lucy
authors.initials: L
authors.lastname: Helyer
authors.forename: Calvin
authors.initials: C
authors.lastname: Law
authors.forename: Simron
authors.initials: S
authors.lastname: Singh
mesh_terms: D016145:Endoscopy, Digestive System / Q000379:methods; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013534:Survival; D013997:Time Factors; D014057:Tomography, X-Ray Computed