Impact of the Surveillance Interval on the Survival of Patients Who Undergo Curative Surgery for Gastric Cancer

Chan Hyuk Park, Jun Chul Park, Hyunsoo Chung, Sung Kwan Shin, SangKil Lee, Jae Ho Cheong, WooJin Hyung, Yongchan Lee, Sung Hoon Noh, Choong Bae Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: For patients who undergo gastrectomy for gastric cancer, systematic follow-up evaluation to detect recurrent lesions is recommended, although the benefits of a surveillance program using short-term imaging studies have not been evaluated. Methods: This study reviewed the clinical data of patients who underwent curative surgery for gastric cancer using a prospective database. Patients with recurrence were classified according to surveillance interval as follows: ≤3, 3–6, and 6–12 months. Results: Of the 2785 patients who underwent curative surgery for gastric cancer, 376 (13.5 %) had intraabdominal recurrences, excluding the stomach. Multivariable analysis showed that a short surveillance interval did not increase the post-recurrence survival duration (with 6–12 months as the reference: ≤3 months: hazard ratio [HR] 0.954; 95 % confidence interval [CI] 0.689–1.323; 3–6 months: HR 0.994, 95 % CI 0.743–1.330). In addition, short surveillance intervals did not increase overall survival (with 6–12 months as the reference: ≤3 months: HR 0.969; 95 % CI 0.699–1.342; 3–6 months: HR 0.955; 95 % CI 0.711–1.285). In contrast to the surveillance interval, age, cancer stage, symptoms at recurrence, and recurrence time after gastrectomy were factors associated with both post-recurrence survival and overall survival. Conclusions: Although the detection of recurrence before symptoms helped to prolong both post-recurrence survival and overall survival, shortening the surveillance interval to less than 6 months did not improve either the patient’s post-recurrence survival or overall survival. Hence, it is not recommended that asymptomatic patients undergo surveillance involving imaging studies more often than once a year.

Original languageEnglish
Pages (from-to)539-545
Number of pages7
JournalAnnals of Surgical Oncology
Volume23
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

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Stomach Neoplasms
Recurrence
Survival
Confidence Intervals
Gastrectomy
Stomach
Databases
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Park, Chan Hyuk ; Park, Jun Chul ; Chung, Hyunsoo ; Shin, Sung Kwan ; Lee, SangKil ; Cheong, Jae Ho ; Hyung, WooJin ; Lee, Yongchan ; Noh, Sung Hoon ; Kim, Choong Bae. / Impact of the Surveillance Interval on the Survival of Patients Who Undergo Curative Surgery for Gastric Cancer. In: Annals of Surgical Oncology. 2016 ; Vol. 23, No. 2. pp. 539-545.
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title = "Impact of the Surveillance Interval on the Survival of Patients Who Undergo Curative Surgery for Gastric Cancer",
abstract = "Background: For patients who undergo gastrectomy for gastric cancer, systematic follow-up evaluation to detect recurrent lesions is recommended, although the benefits of a surveillance program using short-term imaging studies have not been evaluated. Methods: This study reviewed the clinical data of patients who underwent curative surgery for gastric cancer using a prospective database. Patients with recurrence were classified according to surveillance interval as follows: ≤3, 3–6, and 6–12 months. Results: Of the 2785 patients who underwent curative surgery for gastric cancer, 376 (13.5 {\%}) had intraabdominal recurrences, excluding the stomach. Multivariable analysis showed that a short surveillance interval did not increase the post-recurrence survival duration (with 6–12 months as the reference: ≤3 months: hazard ratio [HR] 0.954; 95 {\%} confidence interval [CI] 0.689–1.323; 3–6 months: HR 0.994, 95 {\%} CI 0.743–1.330). In addition, short surveillance intervals did not increase overall survival (with 6–12 months as the reference: ≤3 months: HR 0.969; 95 {\%} CI 0.699–1.342; 3–6 months: HR 0.955; 95 {\%} CI 0.711–1.285). In contrast to the surveillance interval, age, cancer stage, symptoms at recurrence, and recurrence time after gastrectomy were factors associated with both post-recurrence survival and overall survival. Conclusions: Although the detection of recurrence before symptoms helped to prolong both post-recurrence survival and overall survival, shortening the surveillance interval to less than 6 months did not improve either the patient’s post-recurrence survival or overall survival. Hence, it is not recommended that asymptomatic patients undergo surveillance involving imaging studies more often than once a year.",
author = "Park, {Chan Hyuk} and Park, {Jun Chul} and Hyunsoo Chung and Shin, {Sung Kwan} and SangKil Lee and Cheong, {Jae Ho} and WooJin Hyung and Yongchan Lee and Noh, {Sung Hoon} and Kim, {Choong Bae}",
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Impact of the Surveillance Interval on the Survival of Patients Who Undergo Curative Surgery for Gastric Cancer. / Park, Chan Hyuk; Park, Jun Chul; Chung, Hyunsoo; Shin, Sung Kwan; Lee, SangKil; Cheong, Jae Ho; Hyung, WooJin; Lee, Yongchan; Noh, Sung Hoon; Kim, Choong Bae.

In: Annals of Surgical Oncology, Vol. 23, No. 2, 01.02.2016, p. 539-545.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of the Surveillance Interval on the Survival of Patients Who Undergo Curative Surgery for Gastric Cancer

AU - Park, Chan Hyuk

AU - Park, Jun Chul

AU - Chung, Hyunsoo

AU - Shin, Sung Kwan

AU - Lee, SangKil

AU - Cheong, Jae Ho

AU - Hyung, WooJin

AU - Lee, Yongchan

AU - Noh, Sung Hoon

AU - Kim, Choong Bae

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Y1 - 2016/2/1

N2 - Background: For patients who undergo gastrectomy for gastric cancer, systematic follow-up evaluation to detect recurrent lesions is recommended, although the benefits of a surveillance program using short-term imaging studies have not been evaluated. Methods: This study reviewed the clinical data of patients who underwent curative surgery for gastric cancer using a prospective database. Patients with recurrence were classified according to surveillance interval as follows: ≤3, 3–6, and 6–12 months. Results: Of the 2785 patients who underwent curative surgery for gastric cancer, 376 (13.5 %) had intraabdominal recurrences, excluding the stomach. Multivariable analysis showed that a short surveillance interval did not increase the post-recurrence survival duration (with 6–12 months as the reference: ≤3 months: hazard ratio [HR] 0.954; 95 % confidence interval [CI] 0.689–1.323; 3–6 months: HR 0.994, 95 % CI 0.743–1.330). In addition, short surveillance intervals did not increase overall survival (with 6–12 months as the reference: ≤3 months: HR 0.969; 95 % CI 0.699–1.342; 3–6 months: HR 0.955; 95 % CI 0.711–1.285). In contrast to the surveillance interval, age, cancer stage, symptoms at recurrence, and recurrence time after gastrectomy were factors associated with both post-recurrence survival and overall survival. Conclusions: Although the detection of recurrence before symptoms helped to prolong both post-recurrence survival and overall survival, shortening the surveillance interval to less than 6 months did not improve either the patient’s post-recurrence survival or overall survival. Hence, it is not recommended that asymptomatic patients undergo surveillance involving imaging studies more often than once a year.

AB - Background: For patients who undergo gastrectomy for gastric cancer, systematic follow-up evaluation to detect recurrent lesions is recommended, although the benefits of a surveillance program using short-term imaging studies have not been evaluated. Methods: This study reviewed the clinical data of patients who underwent curative surgery for gastric cancer using a prospective database. Patients with recurrence were classified according to surveillance interval as follows: ≤3, 3–6, and 6–12 months. Results: Of the 2785 patients who underwent curative surgery for gastric cancer, 376 (13.5 %) had intraabdominal recurrences, excluding the stomach. Multivariable analysis showed that a short surveillance interval did not increase the post-recurrence survival duration (with 6–12 months as the reference: ≤3 months: hazard ratio [HR] 0.954; 95 % confidence interval [CI] 0.689–1.323; 3–6 months: HR 0.994, 95 % CI 0.743–1.330). In addition, short surveillance intervals did not increase overall survival (with 6–12 months as the reference: ≤3 months: HR 0.969; 95 % CI 0.699–1.342; 3–6 months: HR 0.955; 95 % CI 0.711–1.285). In contrast to the surveillance interval, age, cancer stage, symptoms at recurrence, and recurrence time after gastrectomy were factors associated with both post-recurrence survival and overall survival. Conclusions: Although the detection of recurrence before symptoms helped to prolong both post-recurrence survival and overall survival, shortening the surveillance interval to less than 6 months did not improve either the patient’s post-recurrence survival or overall survival. Hence, it is not recommended that asymptomatic patients undergo surveillance involving imaging studies more often than once a year.

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