Surveillance program for recurrence after curative gastric cancer surgery

Background: It is not clear if more intense surveillance is associated with improved survival after curative resection for gastric cancer. Patients and Methods: A prospectively maintained gastric cancer database was used to identify 402 patients who underwent curative gastrectomy. Multivariate analysis was performed to identify the clinicopathological characteristics associated with long post-recurrence survival. Results: Of 402 patients, 62 patients showed documented recurrence. As shown by multivariate analysis, patients with lymph node metastases originating from primary cancer, symptomatic recurrence, peritoneal dissemination, multiple recurrences and supportive therapy showed a significantly shorter post-recurrence survival. Patients who suffered hematogenous metastases, locoregional recurrence, or recurrence in the remnant stomach had a significantly longer survival time when treated actively compared with those given supportive care. Conclusion: Active treatment is effective in patients with hematogenous metastases, locoregional recurrence, or recurrence in the remnant stomach. Intense surveillance is thus recommended for early identification of such patients.