11-06-2015 | Gastric cancer | Book chapter | Article
19. Surveillance After Gastric Resection
Authors: Domenico D’Ugo, MD, FACS, Alberto Biondi, MD, Andrea Tufo, MD, Gianluca Baiocchi, MD, Roberto Persiani, MD
Publisher: Springer International Publishing
Abstract
After curative gastrectomy, recurrence occurs in a significant proportion of patients and this is inexorably associated with poor outcome in almost all cases. Still there is currently no consensus on the best strategy for surveilling patients who have undergone surgical treatment for gastric cancer.
Considering the poor survival of patients with recurrent gastric cancer and until effective treatments for most patterns of recurrence will be not available, the benefit of early detection of recurrence seems questionable. The wide variation in recommendations for surveillance among international experts and hospital schedules clearly reflects a lack of reliable quality data on this topic. As a consequence most of the international guidelines gloss over details on the mode, duration, and intensity of surveillance, since they cannot be based on an acceptable grade of recommendation.
In recent years an increasing focus on evidence-based medicine, which has coincided with growing concern about costs and efficiency in medicine, has caused a reevaluation of most surveillance practices. In this chapter current evidences and follow-up practices after curative resection of gastric cancer are reviewed.