title: Clinical outcomes of recurrent gastric cancer detected by upper endoscopy after curative total gastrectomy.
abstract: OBJECTIVE
  Endoscopically detected tumor recurrence after curative total gastrectomy is very rare. We reviewed the clinicopathological and endoscopic findings together with the clinical outcomes of these patients.
  
  
  METHODS
  Seventeen patients with recurrent gastric cancer detected by upper gastrointestinal endoscopy who underwent curative total gastrectomy between January 1990 and May 2011 at the Asan Medical Center were analyzed retrospectively.
  
  
  RESULTS
  Of the 17 patients, 5 were resectable at the time of diagnosis of recurrence and 12 were unresectable. The median interval between total gastrectomy and diagnosis of recurrence was 20.2 months (interquartile range 12.4-42.1 months). The tumors were located in the anastomotic area in 8 patients, in the proximal part of the afferent or efferent loop in 7, and in the stump of the afferent loop in 2 patients. With regard to the endoscopic findings, a mass was found in 8 cases, an ulcer in 2, stricture in 4, and nodularities in 3. Operations were performed in 3 patients, chemotherapy in 10 (including 2 receiving adjuvant chemotherapy), and conservative management in 6. Fourteen patients died from progression of the disease and the median survival period from recurrence for all 17 patients was 5.3 months (interquartile range 1.2-7.7 months).
  
  
  CONCLUSIONS
  Local recurrence of gastric cancer detected by upper gastrointestinal endoscopy after curative total gastrectomy has a poor prognosis.
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Hee Kyong
authors.initials: HK
authors.lastname: Na
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Division of Gastroenterology, Departments of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul - Korea.
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
mesh_terms: D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D005743:Gastrectomy / Q000379:methods; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology* / Q000601:surgery*; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*