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

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

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..

Medienart:	E-Artikel

Erscheinungsjahr:	2018
Erschienen:	2018

Enthalten in:	Zur Gesamtaufnahme - volume:21
Enthalten in:	Gastric cancer - 21(2018), 3, Seite 552-568

Sprache:	Englisch

Beteiligte Personen:	Peters, Leila, 1982- [VerfasserIn] Strowitzki, Moritz, 1987- [VerfasserIn] Blank, Susanne, 1984- [VerfasserIn] Nienhüser, Henrik, 1986- [VerfasserIn] Dorr, Sara, 1994- [VerfasserIn] Haag, Georg Martin, 1979- [VerfasserIn] Jäger, Dirk, 1964- [VerfasserIn] Ott, Katja, 1971- [VerfasserIn] Büchler, Markus W., 1955- [VerfasserIn] Ulrich, Alexis [VerfasserIn] Schmidt, Thomas, 1980- [VerfasserIn]

Links:	Volltext

Themen:	Adenocarcinoma Adult Aftercare Aged Aged, 80 and over Esophageal Neoplasms Esophageal cancer Esophagogastric Junction Female Follow-up Gastric cancer Humans Kaplan-Meier Estimate Male Middle Aged Neoplasm Recurrence, Local Prognosis Propensity Score Proportional Hazards Models Recurrence Stomach Neoplasms

Anmerkungen:	Published online: 24 July 2017 Gesehen am 08.07.2019

Umfang:	17

doi:	10.1007/s10120-017-0751-4

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	1668748258

Internformat


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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.
534			\|c 2017
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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