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Improved outcome in asymptomatic recurrence following curative surgery for gastric cancer

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Abstract

The purpose of this study was to compare the outcome and resectability of patients with gastric cancer recurrence after curative surgery detected by follow-up endoscopy, according to the presence or absence of symptoms. All patients with gastric carcinoma, who underwent a curative gastrectomy, were retrospectively identified. We analyzed outcome and survival in patients compliant with routine follow-up who presented symptomatic and asymptomatic recurrence. Of the 119 resected patients, 63.0% had a recurrence, with an overall survival of 20.0 months. Fourteen patients were asymptomatic when recurrence was detected, whereas 61 patients were symptomatic. Median time to recurrence was 16.0 m for both groups. A local curative re-resection was possible in 2/14 (asymptomatic) and 1/61 (symptomatic). Asymptomatic patients had a longer median postrecurrence survival time of 9.0 months, compared with 2.0 months in the symptomatic patients (p=0.034). The median overall survival was greater in the asymptomatic vs symptomatic group (25.0 vs 20.0 months), although this did not reach statistical significance. The results from this study advocate that the presence or absence of symptoms is a good surrogate marker to assess biologic aggressiveness. The value of routine follow-up endoscopy to permit a higher rate of re-resection in asymptomatic patients remains to be established.

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Acknowledgments

Study conception and design: Villarreal-Garza, León-Rodríguez. Collection of data: Villarreal-Garza, Rojas-Flores, Castro-Sánchez. Analysis and interpretation of data: Villarreal-Garza, Villa, León-Rodríguez. Systematic review of literature and drafting of manuscript: Villarreal-Garza, García-Aceituno. Final approval of manuscript: Villarreal-Garza, Rojas-Flores, Castro-Sánchez, Villa, García-Aceituno, León-Rodríguez.

Conflict of interest statement

The authors of the manuscript “Improved outcome in asymptomatic recurrence following curative surgery for gastric cancer” declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Medical Oncology and Hematology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran (INCMNSZ), Vasco de Quiroga 15, Seccion XVI. Del. Tlalpan, C.P. 14000, Mexico City, DF, Mexico

    Cynthia Villarreal-Garza, Miriam Rojas-Flores, Andrea Castro-Sánchez, Luis García-Aceituno & Eucario León-Rodríguez

  2. Department of Clinical Epidemiology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran (INCMNSZ), Mexico City, DF, Mexico

    Antonio R. Villa

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  1. Cynthia Villarreal-Garza
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  2. Miriam Rojas-Flores
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  3. Andrea Castro-Sánchez
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  4. Antonio R. Villa
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  5. Luis García-Aceituno
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  6. Eucario León-Rodríguez
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Correspondence to Cynthia Villarreal-Garza.

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Villarreal-Garza, C., Rojas-Flores, M., Castro-Sánchez, A. et al. Improved outcome in asymptomatic recurrence following curative surgery for gastric cancer. Med Oncol 28, 973–980 (2011). https://doi.org/10.1007/s12032-010-9576-2

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  • DOI: https://doi.org/10.1007/s12032-010-9576-2

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