Annals of surgical oncology · 2014
Follow-up after gastrectomy for cancer: an appraisal of the Italian research group for gastric cancer.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Baiocchi Gian Luca, Marrelli Daniele, Verlato Giuseppe, Morgagni Paolo, Giacopuzzi Simone, Coniglio Arianna, Marchet Alberto, Rosa Fausto, Capponi Michela Giulii, Di Leo Alberto, Saragoni Luca, Ansaloni Luca, Pacelli Fabio, Nitti Donato, D'Ugo Domenico, Roviello Franco, Tiberio Guido A M, Giulini Stefano M, De Manzoni Giovanni
Аннотация
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.
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.
Предметные рубрики MeSH
AdultAgedAged, 80 and overEndoscopy, GastrointestinalFemaleFluorodeoxyglucose F18Follow-Up StudiesGastrectomyHumansItalyLiver NeoplasmsLung NeoplasmsLymph Node ExcisionLymphatic MetastasisMaleMiddle AgedNeoplasm Recurrence, LocalPeritoneal NeoplasmsPhysical ExaminationPositron-Emission TomographyRadiopharmaceuticalsRetrospective StudiesStomachStomach NeoplasmsSurvival RateTime FactorsTomography, X-Ray ComputedUltrasonography