Park Sin Hye, Hyung Woo Jin, Yang Han-Kwang, Park Young-Kyu, Lee Hyuk-Joon, An Ji Yeong, Kim Wook, Kim Hyoung-Il, Kim Hyung-Ho, Ryu Seung Wan, Hur Hoon, Kim Min-Chan, Kong Seong-Ho, Cho Gyu Seok, Kim Jin-Jo, Park Do Joong, Kim Young-Woo, Kim Jong Won, Lee Joo-Ho, Han Sang-Uk, Ryu Keun Won
Centre for Gastric Cancer, National Cancer Centre, Goyang, Korea.
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Br J Surg. 2023 Mar 30;110(4):449-455. doi: 10.1093/bjs/znad002.
The benefit of regular follow-up after curative resection for gastric cancer is controversial as there is no evidence that it will improve survival. This study assessed whether regular follow-up leads to improved survival in patients after surgery for gastric cancer.
A secondary analysis was undertaken of patients who participated in an RCT of laparoscopic versus open distal gastrectomy for advanced gastric cancer between November 2011 and April 2015. Depending on whether patients were compliant with the initial trial follow-up protocol or not, they were analysed as having had either regular or irregular follow-up. Clinicopathological characteristics, recurrence patterns, detection, treatments, and survival were compared between the groups.
The regular and irregular follow-up groups comprised 712 and 263 patients respectively. Disease recurrence within 36 months was more common in the regular group than in the irregular group (17.0 versus 11.4 per cent; P = 0.041). Recurrence patterns did not differ between the groups. The 3-year recurrence-free survival rate was worse in the regular than in the irregular group (81.2 versus 86.5 per cent; P = 0.031). However, the 5-year overall survival rate was comparable (84.5 versus 87.5 per cent respectively; P = 0.160). Multivariable analysis revealed that type of follow-up was not an independent factor affecting 5-year overall survival.
Regular follow-up after radical gastrectomy was not associated with improved overall survival.
胃癌根治性切除术后定期随访的益处存在争议，因为尚无证据表明其能提高生存率。本研究评估了胃癌手术后患者进行定期随访是否能提高生存率。
对2011年11月至2015年4月期间参与晚期胃癌腹腔镜与开腹远端胃切除术随机对照试验的患者进行二次分析。根据患者是否遵守初始试验随访方案，将他们分为接受定期或不定期随访两组进行分析。比较两组的临床病理特征、复发模式、检测、治疗及生存率。
定期随访组和不定期随访组分别有712例和263例患者。定期随访组36个月内的疾病复发比不定期随访组更常见（分别为17.0%和11.4%；P = 0.041）。两组的复发模式无差异。定期随访组的3年无复发生存率低于不定期随访组（分别为81.2%和86.5%；P = 0.031）。然而，5年总生存率相当（分别为84.5%和87.5%；P = 0.160）。多变量分析显示，随访类型不是影响5年总生存率的独立因素。
根治性胃切除术后定期随访与总生存率提高无关。
