The influence of post-operative surveillance on the prognosis after curative surgery for gastric cancer.

Background/aims: Although routine post-operative surveillance after curative resection for gastric cancer is recommended, there are few reports on the value of postoperative follow-up. The aim of this study was to assess the possible role of post-operative surveillance as a prognostic factor after curative resection for gastric cancer.

Methodology: A total of 192 gastric cancer patients who suffered recurrences after curative resection between January 2001 and June 2012 were included in this study. Clinicopathological factors and survival were retrospectively analyzed according to the presence or absence of symptoms related to tumor recurrence at the time of relapse.

Results: One-hundred-and-twenty-six of the patients (65.6%) had asymptomatic recurrences. Peritoneal recurrence (60.6%) predominated among the symptomatic recurrences, whereas locoregional recurrences (42.1%) were dominant among the asymptomatic recurrence. Median recurrence-free survival times did not differ between the two groups (p=0.507). However, median post-recurrence (p<0.001) and overall survival times (p=0.022) were longer in the asymptomatic group.

Conclusions: Time to recurrence did not differ between the symptomatic and asymptomatic recurrence groups, but post-recurrence survival and overall survival were better in the asymptomatic group. Prior to the execution of a large scale randomized controlled trial, close follow-up should be considered.