title: Follow-up: the evidence.
abstract: There is currently no consensus on the best strategy for the follow-up of patients who have undergone surgical treatment with curative intent for gastric cancer. The wide variation in recommendations for surveillance among international experts and hospital schedules clearly reflects a lack of an established body of evidence on this subject. Consequently, most of the international guidelines aimed at early detection of disease recurrence gloss over details concerning the mode, duration, and intensity of surveillance since they cannot be based on an acceptable grade of recommendation. Very few report anything other than the detection of recurrences or death as the primary endpoints, and, given the poor survival of patients with recurrent gastric cancer, the prognostic effect of early detection seems doubtful. In recent years, an increasing focus on evidence-based medicine, which has coincided with a growing concern about costs and efficiency in medicine, has caused a reevaluation of most surveillance practices. In this paper, we review and discuss the current body of evidence and follow-up practices after curative resection of gastric cancer.
authors.affiliation: Department of Surgery, A. Gemelli Hospital, Università Cattolica del Sacro Cuore, IT-00167 Rome, Italy. ddugo@rm.unicatt.it
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Ugo
authors.forename: Alberto
authors.initials: A
authors.lastname: Biondi
authors.forename: Andrea
authors.initials: A
authors.lastname: Tufo
authors.forename: Roberto
authors.initials: R
authors.lastname: Persiani
mesh_terms: D055088:Early Detection of Cancer; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D014943:Global Health; D017408:Guidelines as Topic; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate