Surveillance Endoscopy Guidelines for Postgastrectomy Patients Based on Risk of Developing Remnant Gastric Cancer.

Abstract:

BACKGROUND:Remnant gastric cancer (RGC) has a major impact on the long-term survival of postgastrectomy patients. In this study, we established surveillance endoscopy guidelines for postgastrectomy patients based on the risk of RGC. PATIENTS AND METHODS:A total of 6365 patients who underwent gastrectomy at Seoul St. Mary's Hospital from September 2005 to June 2018 were retrospectively reviewed; 85 patients were identified as having RGC. We divided the RGC patients into subgroups according to the interval between primary and secondary gastrectomy. RESULTS:The curative resection rate was significantly lower in patients with an interval of ≤ 5 years versus > 5 years (p = 0.017). RGC developed more frequently after Billroth II reconstruction, and at the anastomotic site, in patients with a > 10- versus ≤ 10-year interval (p = 0.006 and p = 0.014, respectively). Similar results were observed based on the 15-year interval cutoff (p = 0.001 and 0.018, respectively). The 5-year overall survival rate of patients with a ≤ 5-year interval was significantly lower than that of patients with a > 5-year interval (60.0% versus 85.7%, p = 0.015), while overall survival did not differ between the ≤ 10- and > 10-year, or ≤ 15- and 15-year interval groups. RGC incidence showed a decrease after around 20 years postoperatively. CONCLUSIONS:Thorough endoscopic examination should be conducted for up to 5 years postgastrectomy. Routine annual endoscopic follow-up should be performed for up to 20 years after the primary operation for gastric cancer, to allow for early detection of RGC.

journal_name

Ann Surg Oncol

authors

Han ES,Seo HS,Kim JH,Lee HH

doi

10.1245/s10434-020-08517-3

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

4216-4224

issue

11

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-020-08517-3

journal_volume

27

pub_type

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