Your browser doesn't support javascript.
loading
Symptomatic Recurrence and Survival Outcomes After Curative Treatment of Gastric Cancer: Does Intensive Follow-up Evaluation Improve Survival?
Diniz, Thiago Pereira; da Costa, Wilson L; Gomes, Camila Couto; de Jesus, Victor Hugo F; Felismino, Tiago C; Torres, Silvio Melo; Ribeiro, Héber S C; Diniz, Alessandro L; de Godoy, André Luís; de Farias, Igor Correia; Dias-Neto, Emmanuel; Curado, Maria Paula; Coimbra, Felipe J F.
  • Diniz TP; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • da Costa WL; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • Gomes CC; Department of Medicine, Epidemiology, and Population Sciences, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.
  • de Jesus VHF; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • Felismino TC; Department of Clinical Oncology, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • Torres SM; Department of Clinical Oncology, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • Ribeiro HSC; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • Diniz AL; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • de Godoy AL; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • de Farias IC; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • Dias-Neto E; Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil.
  • Curado MP; Medical Genomics Laboratory, CIPE/A.C. Camargo Cancer Center, São Paulo, Brazil.
  • Coimbra FJF; Cancer Epidemiology and Statistics Group, International Research Center, A. C. Camargo Cancer Center, São Paulo, SP, Brazil.
Ann Surg Oncol ; 29(1): 274-284, 2022 Jan.
Article en En | MEDLINE | ID: mdl-34782973
ABSTRACT

BACKGROUND:

Intensive surveillance after treatment of gastric cancer patients with curative intent may lead to an earlier diagnosis of disease recurrence, but its impact on survival is uncertain. This study aimed to evaluate whether early diagnosis of disease recurrence among asymptomatic patients was associated with long-term survival.

METHODS:

This retrospective study analyzed patients with stages 1 to 3C gastric adenocarcinoma treated between 1999 and 2018. All recurrence events were classified as symptomatic or asymptomatic (detected by follow-up tests), and their clinicopathologic characteristics, patterns of recurrence, and survival were analyzed.

RESULTS:

The cohort consisted of 669 patients treated with a total gastrectomy in 48.6% and a D2-lymphadenectomy in 88.8% of the cases. Most of the tumors were pT3-4 (46.5%), with 45.5% involving lymph node metastases and 42.3% manifesting a diffuse histology. During a median follow-up period of 80.1 months (95% confidence interval [CI], 75.3-84.8 months), 166 patients had recurrences (24.8%), 65.7% of which were symptomatic. The peritoneum was the main site of recurrence (37.2%), and peritoneal recurrence was associated with worse overall survival (OS) (hazard ratio, 1.69; 95%CI, 1.2-2.37). The median disease-free, post-recurrence survival, and OS periods in the asymptomatic and symptomatic groups were respectively 13.4 versus 17.2 months (p = 0.04), 11.9 versus 4.7 months (p < 0.001), and 29.9 versus 26.4 months (p = 0.21). When OS was analyzed among the patients with non-peritoneal recurrence, no difference was observed between the two groups (31.3 vs 31.1 months; p = 0.46).

CONCLUSION:

Early diagnosis of asymptomatic disease recurrence did not affect the OS of the gastric cancer patients treated with curative intent. The use of intensive surveillance strategies in this scenario still requires further evidence.
Asunto(s)
Palabras clave

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neoplasias Gástricas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Año: 2022 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Neoplasias Gástricas Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Humans Idioma: En Año: 2022 Tipo del documento: Article