Postoperative follow-up programs improve survival in curatively resected gastric and junctional cancer patients

• Verfasst von: Peters, Leila [VerfasserIn]
• Verfasst von: Strowitzki, Moritz [VerfasserIn]
• Verfasst von: Blank, Susanne [VerfasserIn]
• Verfasst von: Nienhüser, Henrik [VerfasserIn]
• Verfasst von: Dorr, Sara [VerfasserIn]
• Verfasst von: Haag, Georg Martin [VerfasserIn]
• Verfasst von: Jäger, Dirk [VerfasserIn]
• Verfasst von: Ott, Katja [VerfasserIn]
• Verfasst von: Büchler, Markus W. [VerfasserIn]
• Verfasst von: Ulrich, Alexis [VerfasserIn]
• Verfasst von: Schmidt, Thomas [VerfasserIn]
• Titel: Postoperative follow-up programs improve survival in curatively resected gastric and junctional cancer patients
• Titelzusatz: a propensity score matched analysis
• Verf.angabe: Leila Sisic, Moritz J. Strowitzki, Susanne Blank, Henrik Nienhueser, Sara Dorr, Georg Martin Haag, Dirk Jäger, Katja Ott, Markus W. Büchler, Alexis Ulrich, Thomas Schmidt
• Jahr: 2018
• Jahr des Originals: 2017
• Umfang: 17 S.
• Fussnoten: Published online: 24 July 2017 ; Gesehen am 08.07.2019
• Titel Quelle: Enthalten in: Gastric cancer
• Ort Quelle: Tokyo : Springer, 1998
• Jahr Quelle: 2018
• Band/Heft Quelle: 21(2018), 3, Seite 552-568
• ISSN Quelle: 1436-3305
• DOI: doi:10.1007/s10120-017-0751-4
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adenocarcinoma
• Sach-SW: Adult
• Sach-SW: Aftercare
• Sach-SW: Aged
• Sach-SW: Aged, 80 and over
• Sach-SW: Esophageal cancer
• Sach-SW: Esophageal Neoplasms
• Sach-SW: Esophagogastric Junction
• Sach-SW: Female
• Sach-SW: Follow-up
• Sach-SW: Gastric cancer
• Sach-SW: Humans
• Sach-SW: Kaplan-Meier Estimate
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Neoplasm Recurrence, Local
• Sach-SW: Prognosis
• Sach-SW: Propensity Score
• Sach-SW: Proportional Hazards Models
• Sach-SW: Recurrence
• Sach-SW: Stomach Neoplasms
• K10plus-PPN: 1668748258

Abstract

BACKGROUND: To date there is no evidence that more intensive follow-up after surgery for esophagogastric adenocarcinoma translates into improved survival. This study aimed to evaluate the impact of standardized surveillance by a specialized center after resection on survival. - METHODS: Data of 587 patients were analyzed who underwent curative surgery for esophagogastric adenocarcinoma in our institution. Based on their postoperative surveillance, patients were assigned to either standardized follow-up (SFU) by the National Center for Tumor Diseases (SFU group) or individual follow-up by other physicians (non-SFU group). Propensity score matching (PSM) was performed to compensate for heterogeneity between groups. Groups were compared regarding clinicopathological findings, recurrence, and impact on survival before and after PSM. - RESULTS: Of 587 patients, 32.7% were in the SFU and 67.3% in the non-SFU group. Recurrence occurred in 39.4% of patients and 92.6% within the first 3 years; 73.6% were treated, and of those 17.1% underwent resection. In recurrent patients overall and post-recurrence survival (OS/PRS) was influenced by diagnostic tools (p < 0.05), treatment (p ≤ 0.001), and resection of recurrence (p ≤ 0.001). Standardized follow-up significantly improved OS (84.9 vs. 38.4 months, p = 0.040) in matched analysis and was an independent positive predictor of OS before and after PSM (p = 0.034/0.013, respectively). - CONCLUSION: After PSM, standardized follow-up by a specialized center significantly improved OS. Cross-sectional imaging and treatment of recurrence were associated with better outcome. Regular follow-up by cross-sectional imaging especially during the first 3 years should be recommended by national guidelines, since early detection might help select patients for treatment of recurrence and even resection in few designated cases.