[Value of consistent after care in stomach cancer]

This study analyses the efficacy of a consistent, strict follow-up programme in the management of patients with gastric cancer. Between 1978 and 1986 671 patients were treated, of whom 361 (54%) had a radical operation. The data were fed into an electronic data base and patients were invited to attend the follow-up investigations. The drop-out rate was 21%. Recurrence was detected in 177 cases, 25% in the liver, 25% as carcinosis, 21% in lymph nodes, 15% locally and 14% in other localizations. 78% of the recurrences were seen two years postoperatively and 27% were asymptomatic; 10% underwent radical operation, 27% palliative operation and 63% conservative treatment. Survival rates after 3 and 5 years were 73% and 62% in patients without recurrence and 21% and 8% with recurrence, respectively (p = 0.0 Breslow and Mantel test). The survival rate 2 years after treatment of recurrence was 37% after radical surgery and 0% after palliative operations or conservative treatment (p less than 0.06 Breslow and p less than 0.002 Mantel test). Furthermore, a tight follow-up programme enables control of surgical quality and accurate follow-up during clinical trials, whilst the opportunity to advise patients after operation is an important aspect.