[Proper follow-up schedule after curative gastric surgery]

Area of Science:

• Oncology
• Surgical Gastroenterology
• Cancer Research

Context:

• Gastric cancer (GC) prognosis after R0 resection is generally favorable, but recurrence remains a concern.
• Understanding recurrence patterns is crucial for optimizing post-surgical surveillance.
• This study analyzed recurrence in 307 patients who underwent R0 resection for gastric cancer between 1990 and 2006.

Purpose:

• To investigate the patterns of cancer recurrence after curative gastrectomy (R0 resection).
• To analyze the relationship between tumor differentiation, stage, and recurrence patterns.
• To inform the development of evidence-based follow-up surveillance strategies for gastric cancer patients.

Summary:

• Hematological recurrence was most frequent (41%), followed by peritoneal (33%) and remote lymph nodal (24%).
• Recurrence patterns differed by histology: hematological in differentiated adenocarcinomas, peritoneal/lymph nodal in undifferentiated types.
• Early-stage (pT1) cancers showed high rates of hematological recurrence (83%). Peritoneal recurrence increased with advanced stages (pT3/pT4).
• Most recurrences (91%) occurred within 3 years post-surgery. Survival post-recurrence did not differ significantly across recurrence types.
• Proposed surveillance includes 10 years for early GC and 5 years for advanced GC, with a recommended 5-year check-up.

Impact:

• Provides critical data on gastric cancer recurrence patterns post-R0 resection.
• Highlights the need for tailored surveillance protocols based on tumor characteristics.
• Emphasizes the necessity for further research to confirm the survival benefits of intensive follow-up plans.