IS THE FOLLOW-UP OF PATIENTS OPERATED ON FOR GASTRIC-CARCINOMA OF BENEFIT TO THE PATIENT

In patients operated on for gastric carcinoma, the main purpose of a follow-up program is to diagnose recurrent disease and initiate treatment at an early stage. One hundred and ninety-seven consecutive patients were studied, 43 of whom had not received a resection (27%). Resections were carried out in 144 patients, in either palliative (N = 20), or curative (N = 122) intent. The follow-up program included visits to the outpatient clinic at one month, six months, one year, and every year during the five post-operative years. Shorter intervals were employed as indicated by the functional or general status of the patients. One patient has been lost to follow-up. In palliative surgery, median survival was 3 months in patients undergoing laparotomy, 6 months following palliative surgery without resection, and 8 months following palliative resection. In patients who underwent curative resection, 65 are still alive without recurrent disease (57%). Thirty-six of them have been followed-up for more than 5 years. Seven patients died without recurrence. Of 42 patients with recurrence, 10 underwent a reoperation. The only resection was performed for liver metastasis. This patient died 14 months later. Survival in the 9 other patients did not exceed 6 months. This experience suggests that a follow-up program of patients operated on for gastric carcinoma is disappointing.