Early detection of nonperitoneal recurrence may contribute to survival benefit after curative gastrectomy for gastric cancer

Keiichi Fujiya, Masanori Tokunaga, Rie Makuuchi, Noriyuki Nishiwaki, Hayato Omori, Wataru Takagi, Fumiko Hirata, Makoto Hikage, Yutaka Tanizawa, Etsuro Bando, Taiichi Kawamura, Masanori Terashima

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7 Citations (Scopus)

Abstract

Background: There is no evidence that strict follow-up using cross-sectional imaging after curative gastrectomy benefits survival; however, nonperitoneal recurrence detected early might be treated with additional surgery. The present study examined whether early detection of recurrence by imaging modalities could increase survival, particularly in patients with nonperitoneal recurrence. Methods: We retrospectively analyzed 218 patients with recurrent gastric cancer after curative gastrectomy performed from 2002 to 2014. The patients were divided into an asymptomatic group (n = 117) and a symptomatic group (n = 101), according to the presence of symptoms at the time of recurrence, to compare clinicopathological characteristics and long-term survival. Results: Peritoneal recurrence was less frequent in the asymptomatic group (22.2%) than in the symptomatic group (62.4%), the median time to recurrence was shorter (12.7 months vs 18.9 months; P < 0.001), and the median survival time after recurrence was longer (18.7 months vs 7.5 months; P < 0.001). In the asymptomatic group, 10 of 117 patients (8.5%) received additional curative surgery after recurrence. Median overall survival after gastrectomy was not significantly different between the groups (30.1 months for the asymptomatic group vs 30.0 months for the symptomatic group; P = 0.132); however, it was significantly longer among asymptomatic patients with nonperitoneal recurrence compared with symptomatic patients (35.9 months vs 24.0 months; P = 0.039). Conclusions: The presence of symptoms at recurrence did not affect survival in patients with recurrent gastric cancer. However, detection of nonperitoneal recurrence before the appearance of symptoms may provide survival benefit. Therefore, regular follow-up, including use of imaging modalities, is recommended.

Original languageEnglish
Pages (from-to)141-149
Number of pages9
JournalGastric Cancer
Volume20
DOIs
Publication statusPublished - 2017 Mar 1

Keywords

  • Chemotherapy
  • Computed tomography
  • Follow-up
  • Hematogenous recurrence
  • Hepatectomy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

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  • Cite this

    Fujiya, K., Tokunaga, M., Makuuchi, R., Nishiwaki, N., Omori, H., Takagi, W., Hirata, F., Hikage, M., Tanizawa, Y., Bando, E., Kawamura, T., & Terashima, M. (2017). Early detection of nonperitoneal recurrence may contribute to survival benefit after curative gastrectomy for gastric cancer. Gastric Cancer, 20, 141-149. https://doi.org/10.1007/s10120-016-0661-x