Changing Patterns of Prognosticators During 15-Year Follow-Up of Advanced Gastric Cancer after Radical Gastrectomy and Adjuvant Chemotherapy: A 15-Year Follow-Up Study at a Single Korean Institute |
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Authors: | Yong Wha Moon Hei-Cheul Jeung Sun Young Rha Nae Choon Yoo Jae Kyung Roh Byung Soo Kim " target="_blank">Hyun Cheol Chung |
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Institution: | (1) Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea;(2) Cancer Metastasis Research Center, Yonsei University College of Medicine, Seoul, Korea;(3) Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea;(4) Department of General Surgery, Yonsei University College of Medicine, Seoul, Korea;(5) Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea |
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Abstract: | Background We evaluated the long-term natural history of gastric cancer after radical gastrectomy and adjuvant chemotherapy through a
15-year follow-up study at a single institute.
Methods Five hundred patients with advanced gastric adenocarcinoma who received radical gastrectomy and adjuvant chemotherapy were
included in this long-term follow-up study. Patients were evaluated by imaging studies and upper gastrointestinal series or
endoscopy every 6 months until the 10th year after surgery. Since then, the patients have been followed yearly in the same
manner.
Results The median follow-up period was 190.5 months. The recurrence rate in 5-year survivors was 10.8%. The dominant recurrence pattern
was peritoneal carcinomatosis within 5 years and distant metastasis after 5 years post gastrectomy. Tumor stage was a clear-cut
prognosticator within 5 years post gastrectomy, but was no longer informative in 5–10 years. At this period, only stage IV
(IB–IIIB vs IVM0) was a significantly poor prognosticator. After 10 years, second primary cancer (seven cases) became as important
an issue as recurrence of primary gastric cancer (six cases).
Conclusions In patients with gastric carcinoma treated with radical gastrectomy and adjuvant chemotherapy, late recurrence after 5 years
post gastrectomy was not rare. Prognosticators were varied depending on the length of time after surgery. Tumor factors including
stage were prognosticators within 5 years post gastrectomy, but tumor factors except stage IV had no prognostic value after
5 years. In the 5–10 years post gastrectomy, only stage IV (IB–IIIB vs IVM0) was a poor prognosticator. Also, after 10 years,
there were no prognosticators.
Presented in part at the 42nd Annual Meeting of the American Society of Clinical Oncology, Atlanta, GA, USA. June 2–6, 2006
(abstract No. 4050). |
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Keywords: | Gastric carcinoma Gastrectomy Adjuvant chemotherapy Long-term survivor Prognosis |
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