[Significance of radical recurrent tumor resection for recurrent gastric cancer as assessed by prognosis].
To evaluate the relationship between radical surgery of recurrent tumor and prognosis in cases of recurrent gastric cancer, we analyzed data on 202 patients with relapsed gastric cancer, focusing on surgical recurrent tumor removal. In our series, 18 of the 202 patients underwent radical recurrent tumor resection. Resected tumors were located in the ovarium (n = 4), colorectum (n = 3), liver (n = 3), lymph node (n = 2), locoregional stoma (n = 2), and peritoneum, adrenal gland, brain, and lung (n = 1 each). No surgery-related mortality occurred. One patient remains alive over 5 years after hepatectomy without recurrence, and 17 died within 3 years: 7 patients from primary recurrence and 10 from multiple modes of recurrence. Median survival after recurrence (MSTAR) in the 18 radical surgery patients was 14 months, against 5 months in those treated palliatively (p = 0.0001). MSTAR for the ovary and the liver were 30 months and 15 months in the radical surgery cases, and 2.5 months for the ovary and 5 months for the liver in the palliative cases. Significant differences were thus seen between radical and palliative cases in the ovary (p = 0.010) and in the liver (p = 0.036). Median survival after gastrectomy was 45 months in the radical surgery cases, and 28 months in the palliative cases (p = 0.024). In postoperative gastric cancer follow-up, early detection of recurrence and radical surgery may well benefit patients with relapse, especially in the liver and ovary, in terms of survival.
Kobayashi
O
O
Dept. of Gastrointestinal Surgery, Kanagawa Cancer Center.
Konishi
K
K
Kanari
M
M
Cho
H
H
Yoshikawa
T
T
Tsuburaya
A
A
Sairenji
M
M
Motohashi
H
H
D003110:Colonic Neoplasms / Q000556:secondary / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000556:secondary / Q000601:surgery; D010166:Palliative Care; D011379:Prognosis; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate