title: Different patterns of recurrence in gastric cancer depending on Lauren's histological type: longitudinal study.
abstract: The aim of this multicenter longitudinal study was to evaluate the pattern of recurrence in patients submitted to potentially curative surgery for intestinal-type and diffuse-type gastric cancer. The study included 412 patients surgically treated at three Italian surgical departments, subdivided into 273 intestinal-type cases (group A) and 139 diffuse-type cases (group B). Recurrence of disease was found in 41% of group A cases and 65% of group B cases (p < 0.0001). The incidence of locoregional, hematogenous, and peritoneal recurrence was 20%, 19%, and 9% in group A, and 27%, 16%, and 34% in group B, respectively; the difference between the two groups was statistically significant for peritoneal recurrence (p < 0.0001). Multivariate analysis identified as prognostic variables lymph node status, depth of invasion, extent of lymphadenectomy, advanced age, and male gender in group A; depth of invasion, extent of lymphadenectomy, tumor size, and lymph node status, in group B. Whereas in group A the incidence of peritoneal recurrence was limited in all subgroups examined, in group B very high rates were observed in cases with infiltration of the serosa, involvement of second-level lymph nodes, or large tumor size. The notable difference in the risk of peritoneal recurrence between the intestinal and diffuse types should be taken into consideration in the therapeutic approach to gastric cancer.
authors.affiliation: Chirurgia Oncologica, University of Siena, Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Marrelli
authors.forename: Franco
authors.initials: F
authors.lastname: Roviello
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Manzoni
authors.forename: Paolo
authors.initials: P
authors.lastname: Morgagni
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Leo
authors.forename: Luca
authors.initials: L
authors.lastname: Saragoni
authors.forename: Alfonso
authors.initials: A
authors.lastname: De Stefano
authors.forename: Secondo
authors.initials: S
authors.lastname: Folli
authors.forename: Claudio
authors.initials: C
authors.lastname: Cordiano
authors.forename: Enrico
authors.initials: E
authors.lastname: Pinto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*