Postoperative follow-up programs improve survival in curatively resected gastric and junctional cancer patients: a propensity score matched analysis
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...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2018
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| In: |
Gastric cancer
Year: 2018, Volume: 21, Issue: 3, Pages: 552-568 |
| ISSN: | 1436-3305 |
| DOI: | 10.1007/s10120-017-0751-4 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1007/s10120-017-0751-4
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| Author Notes: | 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 |
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| 245 | 1 | 0 | |a Postoperative follow-up programs improve survival in curatively resected gastric and junctional cancer patients |b a propensity score matched analysis |c 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 |
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| 500 | |a Gesehen am 08.07.2019 | ||
| 520 | |a 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. | ||
| 650 | 4 | |a Adenocarcinoma | |
| 650 | 4 | |a Adult | |
| 650 | 4 | |a Aftercare | |
| 650 | 4 | |a Aged | |
| 650 | 4 | |a Aged, 80 and over | |
| 650 | 4 | |a Esophageal cancer | |
| 650 | 4 | |a Esophageal Neoplasms | |
| 650 | 4 | |a Esophagogastric Junction | |
| 650 | 4 | |a Female | |
| 650 | 4 | |a Follow-up | |
| 650 | 4 | |a Gastric cancer | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Kaplan-Meier Estimate | |
| 650 | 4 | |a Male | |
| 650 | 4 | |a Middle Aged | |
| 650 | 4 | |a Neoplasm Recurrence, Local | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Propensity Score | |
| 650 | 4 | |a Proportional Hazards Models | |
| 650 | 4 | |a Recurrence | |
| 650 | 4 | |a Stomach Neoplasms | |
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