Value of intensive follow-up of patients after curative surgery for gastric carcinoma

Objective: Most clinicians perform surveillance after gastrectomy for gastric cancer. There is no consensus on the regimen, follow-up interval and choice of investigations. This study aims to review the long-term results of patients followed-up in our institution after gastrectomy for gastric cancer. Methods: Patients with gastric carcinoma who had undergone gastrectomy between 1995 and 1998 were reviewed. The patients were assigned to either intensive or regular regimen based on the follow-up they had undergone. Intensive regimen included routine physical examination, serum tumor markers, and the use of computed tomography (CT) scan of more than once per year in the follow-up. Results: A total of 102 patients were reviewed. Forty-nine patients received intensive and 53 patients received regular follow-up. Recurrences were detected earlier in the intensive group (11.5 vs. 19.2 months, P = 0.02). There was no difference in the length of survival in the two groups. Most recurrences (60%) were detected by CT scan. Conclusions: Intensive follow-up after gastrectomy resulted in the earlier detection of recurrences. However, there was no survival benefit from this regimen. A regimen based on symptoms and physical examination is adequate for most patients. CT was the most useful investigation for detection of recurrences.