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Published on: May 10, 2024
Follow-up surveillance for recurrence after curative gastric cancer surgery lacks survival benefit
Yasuhiro Kodera1, Seiji Ito, Yoshitaka Yamamura
1Department of Surgery II, Nagoya University School of Medicine, Aichi, Japan. ykodera@med.nagoya-u.ac.jp
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.
