Follow-up Loss After Curative Gastrectomy for Gastric Cancer: Incidence, Contributing Factors, and Survival Impact

This study examined the incidence, causes, and survival outcomes of follow-up loss (FUL) after a gastrectomy for gastric cancer.

Patients who underwent a curative gastrectomy between January 2016 and May 2019 at a regional tertiary hospital were divided into two groups based on their follow-up (FU) adherence. Patients who maintained a regular FU throughout the five-year period were classified as the FU group, and those who failed to attend their scheduled visits for more than 12 consecutive months were grouped as the FUL group. Telephone interviews were conducted to identify the reasons for FU discontinuation and survival status. The sociodemographic and clinical variables were compared, and the independent predictors and survival outcomes were compared.

Among the 435 patients, 137 (31.5%) were in the FUL group, and contact was successful in 131 patients (95.6%). The leading cause of FUL was death from non-gastric cancer causes (40.1%). Independent predictors of FUL were older age (hazard ratio [HR]=1.044, p<0.001), lower body mass index (BMI, HR=0.927, p=0.015), absence of familial support (HR=2.666, p=0.005), and total gastrectomy (HR=1.660, p=0.012). The BMI lost significance in sensitivity analysis (p=0.293). The overall survival (OS) was lower in the FUL group (p=0.0370), particularly for the stage I patients (p=0.046). The independent predictors of OS were FUL (HR=2.148, p=0.006) and pathologic stage (p<0.001).

FUL after a gastrectomy was associated with older age, absence of familial support, total gastrectomy, and was related to a poorer OS, particularly in stage I patients.