Surveillance Endoscopy Guidelines for Postgastrectomy Patients Based on Risk of Developing Remnant Gastric Cancer
- PDF / 387,409 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 91 Downloads / 173 Views
ORIGINAL ARTICLE – GASTROINTESTINAL ONCOLOGY
Surveillance Endoscopy Guidelines for Postgastrectomy Patients Based on Risk of Developing Remnant Gastric Cancer Eui Soo Han, MD1, Ho Seok Seo, MD2, Ji Hyun Kim, MD2, and Han Hong Lee, MD, PhD2 1
Division of Hepatobiliary Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea; Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 2
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 B 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 B 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 B 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 B 10- and [ 10-year, or B 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
Ó Society of Surgical Oncology 2020 First Received: 23 February 2020 H. H. Lee, MD, PhD e-mail: [email protected]
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.
INTRODUCTION Endoscopy after gastrectomy has been recommended because early detection of gastric cancer increases the survival rate of gastric cancer patients.1, 2 About 30,000 cases of gastric cancer occur annually in Korea, and nearly half of these cases undergo an operation. To date, since 1983, about 200,000 patients in Korea have survived after being diagnosed with gastric cancer.3 Long-term, periodic surveillance endoscopy is very important to prevent recurrence and improve the quality of life of patients who have undergone gastrectomy. While guidelines for endoscopic examination of the healthy stomach have been established, this is not the case for surveillance endoscopy after gastrectomy. The endoscopic findings of postgastrectomy patients in Japan were reported in 2002 and are now widely referred to.4 However, that r
Data Loading...
