title: Postgastrectomy follow-up in the West: evidence base, guidelines, and daily practice.
abstract: Follow-up after gastrectomy for gastric cancer has several purposes, including management of side effects of surgery, oncological recurrence surveillance, psychological support, and data collection for research. How follow-up after gastrectomy, and especially recurrence surveillance, is performed differs immensely between different Western countries, despite guidelines from Western oncological organizations quite unanimously advocating symptom-driven surveillance, without scheduled cross-sectional imaging, endoscopies, or analysis of tumor markers. Given a complete lack of randomized data, the available body of observational data does not support intensive routine surveillance for recurrent disease. Moreover, studies of other cancers have shown a negative emotional impact of routine surveillance. There is an apparent need for randomized controlled trials to address the issue of optimized strategies for postgastrectomy recurrence surveillance.
authors.affiliation: Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Kirurggatan 53, 141 86, Stockholm, Sweden. magnus.nilsson@ki.se.|Center for Digestive Diseases, Karolinska University Hospital, Kirurggatan 53, 141 86, Stockholm, Sweden. magnus.nilsson@ki.se.
authors.forename: Magnus
authors.initials: M
authors.lastname: Nilsson
mesh_terms: D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Follow-up; Gastrectomy; Gastric cancer; Recurrence surveillance