Abstract
Background: Although routine follow-up to detect asymptomatic recurrence after surgery for gastric cancer is recommended, the effect of such reassessment on survival has not been evaluated.
Methods: Clinical records of patients developing recurrent disease after potentially curative resection between 1985 and 1996 were retrieved. Among these patients, 197 were in our follow-up program. We analyzed survival in these patients according to the presence or absence of cancer-related symptoms when recurrent disease was diagnosed.
Results: Of all patients with recurrent disease, 50% were diagnosed within 1 year and 75% within 2 years of surgery. Asymptomatic recurrence, detected in 88 patients (45%), frequently represented distant metastasis. Although early detection significantly improved survival after detection of recurrent disease, disease-free survival for this subset was shorter. Thus, no significant difference in overall survival was observed.
Conclusions: Early detection of asymptomatic gastric cancer recurrence did not improve overall survival of patients with recurrence after curative resection. Until development of more effective treatment for this disease, close follow-up may offer no survival benefit.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Gunderson LL, Donohue JH, Burch PA. Stomach Abeloff MD, Armitage JO, Lichter AS Eds. Clinical Oncology. New York:: Churchill Livingstone, 1995: 1209–41.
Boehner H, Zimmer T, Hopfenmueller W, Berger G, Buhr HJ. Detection and prognosis of recurrent gastric cancer—is routine follow-up after gastrectomy worthwhile? Hepatogastroenterology 2000;47:1489–94.
NCCN practice guidelines for upper gastrointestinal carcinomas. National Comprehensive Cancer Network. Oncology (Huntingt) 1998;12:179–223.
LH Sobin C Wittekind (Eds) (1997) TNM Classification of Malignant Tumours EditionNumber5th ed. Wiley New York
Murad AM, Santiago FF, Petroianu A, Rocha PR, Rodrigues MA, Rausch M. Modified therapy with 5-fluorouracil, doxorubicin and methotrexate in advanced gastric cancer. Cancer 1993;72:37–41.
Glimelius B, Ekstrom K, Hoffman K, et al. Randomized comparison between chemotherapy plus best supportive care with best supportive care in advanced gastric cancer. Ann Oncol 1997;8:163–8.
Pyrhoenen S, Kuitunen T, Nyandoto P, Kouri M. Randomized comparison of 5-fluorouracil, epidoxorubicin, and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. Br J Cancer 1995;71:587–91.
Boku N, Ohtsu A, Shimada Y, et al. Phase II study of a combination of irinotecan and cisplatin against metastatic gastric cancer. J Clin Oncol 1999;17:319–23.
Sakata Y, Ohtsu A, Horikoshi N, Sugimachi K, Mitachi Y, Taguchi T. Late phase II study of novel oral fluoropyrimidine anticancer drug S-1 in advanced gastric cancer patients. Eur J Cancer 1998;34:1715–20.
Yoo CH, Noh SH, Shin DW, Choi SH, Min JS. Recurrence following curative resection for gastric carcinoma. Br J Surg 2000;87:236–42.
Howell JD, Wotherspoon H, Leen E, Cooke TC, McArdle CS. Evaluation of a follow-up programme after curative resection for colorectal cancer. Br J Cancer 1999;79:308–10.
Yasui K, Hirai T, Kato T, et al. A new macroscopic classification predicts prognosis for patients with liver metastases from colorectal cancer. Ann Surg 1997;226:582–6.
Saiura A, Umekita N, Inoue S, et al. Clinicopathological features and outcome of hepatic resection for liver metastasis from gastric cancer. Hepatogastroenterology 2002;49:1062–5.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kodera, Y., Ito, S., Yamamura, Y. et al. Follow-Up Surveillance for Recurrence After Curative Gastric Cancer Surgery Lacks Survival Benefit. Ann Surg Oncol 10, 898–902 (2003). https://doi.org/10.1245/ASO.2003.12.009
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1245/ASO.2003.12.009