Malaysia
Search
Sign In
Gastric%20cancer Management
Follow Up
- A regular follow-up may allow investigation and treatment of symptoms, psychological support and early detection of recurrence, though there is no evidence that it improves survival outcomes
- Response to systemic treatments should normally be assessed with interval computed tomography (CT) imaging of chest, abdomen and pelvis
- In the advanced disease setting, identification of patients for second-line chemotherapy and clinical trials requires regular follow-up to detect symptoms of disease progression before significant clinical deterioration
- The type of pathological response and histologic tumor regression after neoadjuvant therapy has been shown to be a predictor of survival
- Follow-up should include a complete history and physical examination every 3-6 months for 1-2 years, every 6-12 months for 3-5 years and annually thereafter
- Patients who have undergone surgical resection should be monitored and treated as indicated for vitamin B12 and iron deficiency
- Endoscopic surveillance requires multiple (4-6) biopsies of any visualized abnormalities after definitive treatment of gastric cancer
- Strictures found on endoscopy should be biopsied
- Endoscopic ultrasound-guided fine needle aspiration is recommended if areas of wall thickening or suspicious lymph nodes are noted
- Patients with Tis and successfully treated with endoscopic resection should undergo EGD every 6 months for 1 year then annually for 3 years
- Patients with pathologic stage I who underwent surgical resection for T1a, T1b, N0-1 or endoscopic resection for T1a should undergo EGD every 6 months for 1 year then annually for 5 years with subsequent follow-ups based on symptoms or radiologic findings
- Patients with pathologic stage II/III or postneoadjuvant stage I-III who underwent neoadjuvant therapy with or without adjuvant therapy should have CT scans of the chest, abdomen and pelvis every 6-12 months for the first 2 years, then annually up to 5 years with subsequent follow-ups based on risk factors and comorbidities
