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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2014

01-06-2014 | Gastrointestinal Oncology

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

Authors: Gian Luca Baiocchi, MD, Daniele Marrelli, MD, Giuseppe Verlato, MD, Paolo Morgagni, MD, Simone Giacopuzzi, MD, Arianna Coniglio, MD, Alberto Marchet, MD, Fausto Rosa, MD, Michela Giulii Capponi, MD, Alberto Di Leo, MD, Luca Saragoni, MD, Luca Ansaloni, MD, Fabio Pacelli, MD, Donato Nitti, MD, Domenico D’Ugo, MD, Franco Roviello, MD, Guido A. M. Tiberio, MD, Stefano M. Giulini, MD, Giovanni De Manzoni, MD

Published in: Annals of Surgical Oncology | Issue 6/2014

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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.
Appendix
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Metadata
Title
Follow-Up After Gastrectomy for Cancer: An Appraisal of the Italian Research Group for Gastric Cancer
Authors
Gian Luca Baiocchi, MD
Daniele Marrelli, MD
Giuseppe Verlato, MD
Paolo Morgagni, MD
Simone Giacopuzzi, MD
Arianna Coniglio, MD
Alberto Marchet, MD
Fausto Rosa, MD
Michela Giulii Capponi, MD
Alberto Di Leo, MD
Luca Saragoni, MD
Luca Ansaloni, MD
Fabio Pacelli, MD
Donato Nitti, MD
Domenico D’Ugo, MD
Franco Roviello, MD
Guido A. M. Tiberio, MD
Stefano M. Giulini, MD
Giovanni De Manzoni, MD
Publication date
01-06-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 6/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3534-8

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