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Erschienen in: Gastric Cancer 3/2018

01.05.2018 | Original Article

Postoperative follow-up programs improve survival in curatively resected gastric and junctional cancer patients: a propensity score matched analysis

verfasst von: 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

Erschienen in: Gastric Cancer | Ausgabe 3/2018

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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.
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Metadaten
Titel
Postoperative follow-up programs improve survival in curatively resected gastric and junctional cancer patients: a propensity score matched analysis
verfasst von
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
Publikationsdatum
01.05.2018
Verlag
Springer Japan
Erschienen in
Gastric Cancer / Ausgabe 3/2018
Print ISSN: 1436-3291
Elektronische ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-017-0751-4

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