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World J Gastroenterol. Sep 14, 2014; 20(34): 11966-11971
Published online Sep 14, 2014. doi: 10.3748/wjg.v20.i34.11966
Follow-up after gastrectomy for cancer: Results of an international web round table
Gian Luca Baiocchi, Yasuhiro Kodera, Daniele Marrelli, Fabio Pacelli, Paolo Morgagni, Franco Roviello, Giovanni De Manzoni
Gian Luca Baiocchi, Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, Brescia 25123, Italy
Yasuhiro Kodera, Department of Gastroenterological Surgery, Surgery II, Nagoya University, Nagoya 452-0813, Japan
Daniele Marrelli, Franco Roviello, Department of Human Pathology and Oncology, Surgical Oncology, Siena University, Siena 53011, Italy
Paolo Morgagni, Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì 47121, Italy
Fabio Pacelli, Department of Surgical Sciences, Digestive Surgery, Catholic University, Rome 00118, Italy
Giovanni De Manzoni, 1st Department of General Surgery, Borgo Trento Hospital, University of Verona, Verona 37121, Italy
Author contributions: Morgagni P was responsible for study concept and design; Baiocchi GL was the chairman of the web round table; Kodera Y, Marrelli D and Pacelli F were the co-chairmen of the web round table and were responsible for acquisition of data; Baiocchi GL wrote the paper; Roviello F and De Manzoni G critically reviewed the paper for intellectual content.
Correspondence to: Gian Luca Baiocchi, MD, Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, Piazzale Spedali Civili 1, Brescia 25123, Italy. gianluca.baiocchi@unibs.it
Telephone: +39-338-5949921 Fax: +39-30-3995600
Received: October 26, 2013
Revised: January 7, 2014
Accepted: July 22, 2014
Published online: September 14, 2014
Processing time: 327 Days and 12.6 Hours
Abstract

Oncological follow-up after radical gastrectomy for cancer still represents a discrepancy in the field, with many retrospective series demonstrating that early diagnosis of recurrence does not result in an improvement in patient survival; yet, many centers with high quality of care still provide routine patient follow-up after surgery by clinical and instrumental controls. This was the topic for a web round table entitled “Rationale and limits of oncological follow-up after gastrectomy for cancer” that was launched one year before the 10th International Gastric Cancer Congress. Authors having specific expertise were invited to comment on their previous publications to provide the subject for an open debate. During a three-month-long discussion, 32 authors from 12 countries participated, and 2299 people visited the dedicated web page. Substantial differences emerged between the participants: authors from Japan, South Korea, Italy, Brazil, Germany and France currently engage in instrumental follow-up, whereas authors from Eastern Europe, Peru and India do not, and British and American surgeons practice it in a rather limited manner or in the context of experimental studies. Although endoscopy is still considered useful by most authors, all the authors recognized that computed tomography scanning is the method of choice to detect recurrence; however, many limit follow-up to clinical and biochemical examinations, and acknowledge the lack of improved survival with early detection.

Keywords: Gastric cancer; Recurrence; Follow-up; Diagnosis; Prognosis; Surgery; Chemotherapy

Core tip: A web round table entitled “Rationale and limits of oncological follow-up after gastrectomy for cancer” was launched in 2012 in preparation for the 10th International Gastric Cancer Congress. A total of 32 authors from 12 countries participated in a three-month-long discussion, and 2299 people visited the dedicated web page. The discussion revealed that the practice of follow-up after radical gastrectomy for cancer is not homogenously applied worldwide. The differences are related to culture, health system organization, and level of care.