Timing and Pattern of Recurrence after Gastrectomy for Adenocarcinoma

Gastric adenocarcinoma has a high recurrence rate. The goal of this study was to determine the timing and pattern of recurrence after gastrectomy. A retrospective review was performed of patients with gastric adenocarcinoma having curative partial or total gastrectomy with R0/D2 lymph node resection...

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Bibliographic Details
Published in:The American surgeon 2015-10, Vol.81 (10), p.1057-1060
Main Authors: Alnoor, Mohammad, Boys, Joshua A, Worrell, Stephanie G, Oh, Daniel S, Hagen, Jeffrey A, DeMeester, Steven R
Format: Article
Language:English
Subjects:
Abdomen
Adenocarcinoma - diagnosis
Adenocarcinoma - surgery
Aged
Biopsy
California - epidemiology
Cancer therapies
Cellular biology
Chemotherapy
Dissection
Endoscopy
Female
Follow-Up Studies
Gastrectomy - methods
Gastric cancer
Gastroscopy
Humans
Incidence
Lymphatic system
Male
Medical prognosis
Metastasis
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Neoplasm Staging
Patients
Prognosis
Retrospective Studies
Stomach Neoplasms - diagnosis
Stomach Neoplasms - surgery
Studies
Survival Rate - trends
Time Factors
Tomography, X-Ray Computed
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Summary:Gastric adenocarcinoma has a high recurrence rate. The goal of this study was to determine the timing and pattern of recurrence after gastrectomy. A retrospective review was performed of patients with gastric adenocarcinoma having curative partial or total gastrectomy with R0/D2 lymph node resection from 1999 to 2013. Follow-up included CT scans of the chest, abdomen, and pelvis at 3-month intervals for the first three years, at 6-month intervals for the next two years, and annually thereafter. There were 62 patients, 38 males and 24 females, with a median age of 65 years. Median follow-up was 29 months and recurrence was identified in 21 per cent of patients. Median time to recurrence was 12 months and 92 per cent of recurrences occurred within two years. The last recurrence was identified at 34 months. Abdominal CT scan identified all patients with recurrence, although some patients had disease elsewhere in addition to the abdominal disease. There were no extra-abdominal isolated recurrences. In conclusion, recurrence after complete resection for gastric adenocarcinoma typically occurs within the first two years, and can be found by abdominal CT scan. Close cancer follow-up appears unnecessary after three years because all recurrences were identified within 34 months of resection.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481508101029