Postoperative Follow-up of Early Gastric Cancer

Article information

J Korean Med Assoc. 2010;53(4):324-330

Publication date (electronic) : 2010 January 17

doi : https://doi.org/10.5124/jkma.2010.53.4.324

Department of Surgery, Seoul National University College of Medicine

Abstract

Since early gastric cancer (EGC) patients show an excellent surgical outcome and a longterm survival rate, the purpose and methods of postoperative followup need to be reconsidered. The recurrence rate after surgery is less than 2% in EGC. The mode of recurrence is diverse, of which hematogeous metastasis being most frequently encountered. Post-gastrectomy patients have a risk of nutritional deficiency and more chances to develop remnant gastric tumor or secondary tumor than normal population. Based on the pattern and developmental time span of recurrence, postoperative followup program for EGC should not be different from that for advanced gastric cancer. Most Korean doctors? postoperative followup with the patients range up to 5 years with an interval of 4 to 6 months. Gastroscopy, CT, and tumor markers are used for followup by more than 50% of doctors. Due to the increased rate of longterm survival, followup program should include assessment of functional aspect and nutritional well-being of the patients. Epidemiological studies for the longterm survivors and specialized strategies need to be developed for management of postgastrectomy cancer patients. Although early detection of recurrence is the primary goal of postoperative followup, postgastrectomy patients should be recognized as a risk group in terms of nutritional and medical problems on a life-long basis, and longterm management strategy should be developed.

Keywords: Early gastric cancer; Follow-up; Guality of life; Remnant gastric cancer

Table 1.

Recurrence rate of early gastric cancer according to 6^th stage TNM in Seoul National University Hospital (n=1,447)

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Table 1.

Recurrence rate of early gastric cancer according to 6^th stage TNM in Seoul National University Hospital (n=1,447)

	N0	N1	N2	Total
T1a	2/700 0.29%	1/24 4.17%	2/8 25.0%	5/732 0.68%
T1b	5/555	5/140	6/20	16/715
	0.90%	3.57%	30.0%	2.24%
Total	7/1255	6/164	8/28	21/1,447
	0.56%	3.66%	28.6%	1.45%