Local recurrence of gastric adenocarcinomas after gastrectomy.
A study of 257 gastric cancer patients treated with gastrectomy and followed to their death showed that (a) the incidence of local recurrence in the field of gastrectomy was 25%; (b) from the three types of gastrectomy used, extended total gastrectomy resulted in the lowest incidence of recurrence, followed by subtotal and total; (c) recurrences were more common in patients with TNM stages I, II, and III tumors where extended total gastrectomy was proven superior (p less than 0.05); (d) early stage tumors tended to recur in the gastric remnant and the esophagus; (e) narrow surgical margins and margins involved by disease predisposed to recurrence; (f) not every patient with histologically invaded margins developed recurrence; (g) the risk of recurrence did not decrease with time; (h) the longer the disease-free interval the better the prognosis; (i) the more advanced the original lesion the longer the disease-free interval; (j) of all patients with recurrence only 19% had resectable lesions on reexploration; (k) the longer the disease-free interval the higher the resectability rate; (l) the median interval from recurrence to death was 2 months; (m) the same interval of those undergoing resection was 18 months. Patients with early-stage tumors treated with gastrectomy should be followed closely for local recurrence and should recurrence develop they should be reexplored if there is no evidence of metastasis.
D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005743:Gastrectomy; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D013997:Time Factors