title: Follow-up after gastrectomy for cancer: an appraisal of the Italian research group for gastric cancer.
abstract: BACKGROUND
  The Italian Research Group for Gastric Cancer supports the practice of follow-up after radical surgery for gastric cancer.
  
  
  METHODS
  This multicenter, retrospective study (1998-2009) included patients with T1-4N0-3M0 gastric cancer who had undergone D2 gastrectomy and lymphadenectomy, with at least 15 lymph nodes examined, and who had developed recurrent disease. Timing and site of recurrence were correlated to the actual scheduled follow-up timing and modalities.
  
  
  RESULTS
  From eight centers, 814 patients with recurrent cancer and over 1,754 (46.4 %) patients undergoing gastrectomy were investigated (median follow-up 31 months). The most frequent sites of recurrence were local/regional lymph nodes (35.4 %), liver (24.3 %), peritoneum (30.3 %), lung (10.4 %) and intraluminal (7.5 %). Ninety-four percent of the recurrences were diagnosed within 2 years and 98 % within 3 years. Thoracoabdominal computed tomography (CT) scan and (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (18-FDG-PET) detected more than 90 % of recurrences, abdominal ultrasound detected 70 % and tumor markers detected 40 %, while <10 % were identified by physical examination, chest X-ray, and upper gastrointestinal endoscopy. Twenty-six percent of patients with recurrence were treated, but only 3.2 % were treated with potentially radical intent.
  
  
  CONCLUSIONS
  Oncological follow-up after radical surgery for gastric cancer should be focused in the first 3 years, and based mainly on thoracoabdominal CT scan and 18-FDG-PET.
authors: Department of Clinical and Experimental Sciences, Surgical Clinic, Brescia University, Brescia, Italy, baioksurg@hotmail.com.
authors: Gian Luca
authors: GL
authors: Baiocchi
authors: Daniele
authors: D
authors: Marrelli
authors: Giuseppe
authors: G
authors: Verlato
authors: Paolo
authors: P
authors: Morgagni
authors: Simone
authors: S
authors: Giacopuzzi
authors: Arianna
authors: A
authors: Coniglio
authors: Alberto
authors: A
authors: Marchet
authors: Fausto
authors: F
authors: Rosa
authors: Michela Giulii
authors: MG
authors: Capponi
authors: Alberto
authors: A
authors: Di Leo
authors: Luca
authors: L
authors: Saragoni
authors: Luca
authors: L
authors: Ansaloni
authors: Fabio
authors: F
authors: Pacelli
authors: Donato
authors: D
authors: Nitti
authors: Domenico
authors: D
authors: D'Ugo
authors: Franco
authors: F
authors: Roviello
authors: Guido A M
authors: GA
authors: Tiberio
authors: Stefano M
authors: SM
authors: Giulini
authors: Giovanni
authors: G
authors: De Manzoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D007558:Italy; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D010808:Physical Examination; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013270:Stomach; D013274:Stomach Neoplasms / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18