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Follow-Up After Gastrectomy for Cancer: An Appraisal of the Italian Research Group for Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The Italian Research Group for Gastric Cancer supports the practice of follow-up after radical surgery for gastric cancer.

Methods

This multicenter, retrospective study (1998–2009) included patients with T1-4N0-3M0 gastric cancer who had undergone D2 gastrectomy and lymphadenectomy, with at least 15 lymph nodes examined, and who had developed recurrent disease. Timing and site of recurrence were correlated to the actual scheduled follow-up timing and modalities.

Results

From eight centers, 814 patients with recurrent cancer and over 1,754 (46.4 %) patients undergoing gastrectomy were investigated (median follow-up 31 months). The most frequent sites of recurrence were local/regional lymph nodes (35.4 %), liver (24.3 %), peritoneum (30.3 %), lung (10.4 %) and intraluminal (7.5 %). Ninety-four percent of the recurrences were diagnosed within 2 years and 98 % within 3 years. Thoracoabdominal computed tomography (CT) scan and (18)F-fluoro-2-deoxy-d-glucose positron emission tomography (18-FDG-PET) detected more than 90 % of recurrences, abdominal ultrasound detected 70 % and tumor markers detected 40 %, while <10 % were identified by physical examination, chest X-ray, and upper gastrointestinal endoscopy. Twenty-six percent of patients with recurrence were treated, but only 3.2 % were treated with potentially radical intent.

Conclusion

Oncological follow-up after radical surgery for gastric cancer should be focused in the first 3 years, and based mainly on thoracoabdominal CT scan and 18-FDG-PET.

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Authors and Affiliations

  1. Department of Clinical and Experimental Sciences, Surgical Clinic, Brescia University, Brescia, Italy

    Gian Luca Baiocchi MD, Arianna Coniglio MD, Guido A. M. Tiberio MD & Stefano M. Giulini MD

  2. Department of Human Pathology and Oncology, Surgical Oncology, Siena University, Siena, Italy

    Daniele Marrelli MD & Franco Roviello MD

  3. Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy

    Giuseppe Verlato MD

  4. Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy

    Paolo Morgagni MD & Luca Saragoni MD

  5. 1st Department of General Surgery, Borgo Trento Hospital, University of Verona, Verona, Italy

    Simone Giacopuzzi MD & Giovanni De Manzoni MD

  6. II Surgical Clinic, Padova University, Padua, Italy

    Alberto Marchet MD & Donato Nitti MD

  7. Department of Surgical Sciences, Catholic University, Rome, Italy

    Fausto Rosa MD, Fabio Pacelli MD & Domenico D’Ugo MD

  8. General Surgery I, Ospedali Riuniti, Bergamo, Italy

    Michela Giulii Capponi MD & Luca Ansaloni MD

  9. General Surgery Unit, Arco Hospital, APSS of Trento, Trento, Italy

    Alberto Di Leo MD

  10. Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, Brescia, Italy

    Gian Luca Baiocchi MD

Authors
  1. Gian Luca Baiocchi MD
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  2. Daniele Marrelli MD
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  18. Stefano M. Giulini MD
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  19. Giovanni De Manzoni MD
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Corresponding author

Correspondence to Gian Luca Baiocchi MD.

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Baiocchi, G.L., Marrelli, D., Verlato, G. et al. Follow-Up After Gastrectomy for Cancer: An Appraisal of the Italian Research Group for Gastric Cancer. Ann Surg Oncol 21, 2005–2011 (2014). https://doi.org/10.1245/s10434-014-3534-8

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  • DOI: https://doi.org/10.1245/s10434-014-3534-8

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