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Impact of the Surveillance Interval on the Survival of Patients Who Undergo Curative Surgery for Gastric Cancer

Park CH, Park JC, Chung H, Shin SK, Lee SK, Cheong JH, et al.

Ann Surg Oncol. 2016 Feb;23(2):539-45.  

Abstract
 

BACKGROUND:

For patients who undergo gastrectomy for gastric cancer, systematic follow-up evaluation to detect recurrent lesions is recommended, although the benefits of a surveillance program using short-term imaging studies have not been evaluated.

METHODS:

This study reviewed the clinical data of patients who underwent curative surgery for gastric cancer using a prospective database. Patients with recurrence were classified according to surveillance interval as follows: ≤3, 3-6, and 6-12 months.

RESULTS:

Of the 2785 patients who underwent curative surgery for gastric cancer, 376 (13.5 %) had intraabdominal recurrences, excluding the stomach. Multivariable analysis showed that a short surveillance interval did not increase the post-recurrence survival duration (with 6-12 months as the reference: ≤3 months: hazard ratio [HR] 0.954; 95 % confidence interval [CI] 0.689-1.323; 3-6 months: HR 0.994, 95 % CI 0.743-1.330). In addition, short surveillance intervals did not increase overall survival (with 6-12 months as the reference: ≤3 months: HR 0.969; 95 % CI 0.699-1.342; 3-6 months: HR 0.955; 95 % CI 0.711-1.285). In contrast to the surveillance interval, age, cancer stage, symptoms at recurrence, and recurrence time after gastrectomy were factors associated with both post-recurrence survival and overall survival.

CONCLUSIONS:

Although the detection of recurrence before symptoms helped to prolong both post-recurrence survival and overall survival, shortening the surveillance interval to less than 6 months did not improve either the patient's post-recurrence survival or overall survival. Hence, it is not recommended that asymptomatic patients undergo surveillance involving imaging studies more often than once a year.

©PubMed Central


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