조기위암의 수술 후 추적관리

Abstract

Since early gastric cancer (EGC) patients show an excellent surgical outcome and a long-term survival rate, the purpose and methods of postoperative follow-up need to be reconsidered. The recurrence rate after surgery is less than 2% in EGO. The mode of recurrence is diverse, of which hematogeous metastasis being most frequently encountered. Post-gastrectomy patients have a risk of nutritional deficiency and more chances to develop remnant gastric tumor or secondary tumor than normal population. Based on the pattern and developmental time span of recurrence, postoperative follow-up program for EGO should not be different from that for advanced gastric cancer. Most Korean doctors` post-operative follow-up with the patients range up to 5 years with an interval of 4 to 6 months. Gastroscopy. CT, and tumor markers are used for follow-up by more than 50% of doctors. Due to the increased rate of long-term survival, follow-up program should include assessment of functional aspect and nutritional well-being of the patients. Epidemiological studies for the long-term survivors and specialized strategies need to be developed for management of postgastrectomy cancer patients. Although early detection of recurrence is the primary goal of post-operative follow-up. postgastrectomy patients should be recognized as a risk group in terms of nutritional and medical problems on a life-long basis, and long-term management strategy should be developed.