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Predictive Role of Endoscopic Surveillance after Total Gastrectomy with R0 Resection for Gastric Cancer

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Abstract
Background: Endoscopic surveillance after total gastrectomy (TG) for gastric cancer is routinely performed to detect tumor recurrence and postoperative adverse events. However, the reports on the clinical benefits of endoscopic surveillance are ambiguous. We investigated the clinical benefit of endoscopic surveillance after TG for gastric cancer.

Methods: We analyzed 848 patients who underwent TG with R0 resection for gastric cancer between 2011 and 2012 (380 early gastric cancer and 468 advanced gastric cancer) and underwent regular postoperative surveillance with endoscopy and abdominopelvic computed tomography (CT) with contrast.

Results: Median follow-up periods were 58 months for both endoscopy (range, 3-96) and abdominopelvic CT (range, 1-96). Tumor recurrence occurred in 167 patients (19.7%), of whom seven (4.2%) were locoregional recurrences in the peri- anastomotic area (n = 5) or regional gastric lymph nodes (n = 2). Whereas the peri-anastomotic recurrences were detected by both endoscopy and abdominopelvic CT, regional lymph node recurrences were only detected by abdominopelvic CT. Out of the 23 events of postoperative adverse events, the majority (87%) were detected by radiologic examinations; three events of benign strictures in the anastomotic site were detected only by endoscopy.

Conclusion: Endoscopic surveillance did not have a significant role in detecting locoregional tumor recurrence and postoperative adverse events after TG with R0 resection for gastric cancer. Routine endoscopic surveillance after TG may be considered optional and performed according to the capacities of each clinical setting.
Author(s)
김도훈김진영나희경송호준안지용이정수이정훈이진혁정기욱정훈용최기돈
Issued Date
2021
Type
Article
Keyword
EndoscopySurveillanceGastric CancerTotal GastrectomyLocoregional RecurrencePostoperative Adverse Events
DOI
10.3346/jkms.2021.36.e88
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7917
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9773941&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Predictive%20Role%20of%20Endoscopic%20Surveillance%20after%20Total%20Gastrectomy%20with%20R0%20Resection%20for%20Gastric%20Cancer&offset=0&pcAvailability=true
Publisher
JOURNAL OF KOREAN MEDICAL SCIENCE
Location
대한민국
Language
영어
ISSN
1011-8934
Citation Volume
36
Citation Number
14
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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