Surveillance and outcomes after curative resection for gastroesophageal adenocarcinoma

摘要: Background: The goal of surveillance testing is to enable curative salvage therapy through early disease detection, however supporting evidence in gastroesophageal adenocarcinoma limited. We evaluated frequency successful and outcomes patients who underwent surveillance. Methods: A single-site, retrospective cohort study was conducted identify all received resection for adenocarcinoma. Surveillance were those investigations not triggered by abnormal symptoms, physical examination, or blood tests. Successful any potentially recurrence which resulted postrecurrence disease-free survival ≥2 years. Time-to-event data analyzed using the Kaplan-Meier method log rank Results: Between 2011 2016, 210 consecutive reviewed. Esophageal (14%), junction (40%), gastric adenocarcinomas (45%) treated with surgery alone (29%) multimodality (71%). Adjuvant administered 35%. At median follow-up 38.3 months, 5-year overall (OS) rate 56%. Among 97 recurrences, 53% surveillance-detected, 46% symptomatic. None detected endoscopy. Median time-to-recurrence (TTR) 14.8 months. Recurrences included locoregional only (4%), distant (86%), both (10%). Salvage attempted 15 patients, 4 successful. Compared symptomatic surveillance-detected recurrences had longer OS (36.2 vs 23.7 months, P =.004) (PRS, 16.5 4.6 months, P <.001), but similar TTR (16.2 13.3 months, P =.40) duration palliative chemotherapy (3.9 3.3 months, P =.64). Conclusions: surveyed, 96% distant, 1.9% patients. Longer compared associated significant earlier may be contributed differences biology. Further prospective are warranted establish benefit