What Follow-Up for Early Gastric Cancer Patients Radically Treated? – Pages 1-5

Baiocchi Gian Luca1, Guido Alberto Massimo Tiberio1, Nazario Portolani1, Arianna Coniglio1, Federico Gheza1, Sarah Molfino1, Paolo Morgagni2, Luca Saragoni3, Giovanni De Manzoni4 and Stefano Maria Giulini1

1Surgical Clinic, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; 2Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy; 3Department of Pathology, G.B. Morgagni-L. Pierantoni Hospital, Forlì, Italy; 41st Dept. of General Surgery, Borgo Trento Hospital, University of Verona, Verona, Italy;

DOI: http://dx.doi.org/10.12974/2309-6160.2013.01.01.1

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Abstract: Introduction: At the present state of knowledge, submitting patients radically operated for Early Gastric Cancer (EGC) to an imaging-based oncological follow-up doesn’t improve survival.

Materials and Methods: The present study was performed consulting the available Literature in PubMed and Embase. Manuscripts published in the period 1990-2012 were selected. A research inboard the Italian Research Group for Gastric Cancer (IRGGC) was also managed.

Results: After radical resection for EGC, the 5-years risk of recurrence is 1.7%-6.8%; the risk of another tumor is 1.2%- 4.8%, so follow-up could be useless in almost 90% of cases. However, a lot of patients actually require to be followed over time after the intervention; furthermore, follow up is the only practice that should provide reliable data about time and mode of recurrence. Indeed, many high quality and high volume centers all around the world, and 100% of the 8 IRGGC Centers involved in this survey keep their patients currently under control. Looking for a rational approach, follow-up has to be especially considered for N+ patients, it has to last 5 years long and it must be based on CT with i.v. contrast medium injection alternating to abdominal ultrasonography.

Conclusions: Despite the absence of a clear survival advantage, the practice of follow-up after radical gastrectomy for EGC should be supported.

Keywords: Early gastric cancer, surgery, follow-up, prognosis, CT scan, chemotherapy.