title: Early and late recurrences after gastrectomy for gastric cancer: a multiple logistic regression analysis.
abstract: OBJECTIVE
  Although many studies have focused on clinical risk factors for prognosis of patients with surgically treated gastric cancer, little information is available regarding the timing of recurrent malignant disease. The purpose of this study was to determine the factors that are predictive of early and late recurrences after gastrectomy.
  
  
  METHODS
  We reviewed the hospital records of patients with hisotological proof of gastric cancer who were admitted to Sendai National Hospital during the period from 1985 to 1995. A total of 923 records were examined, and 251 patients with recurrent disease were identified. The patients were divided into an "early recurrence group" consisting of 195 patients (died within one year after surgery) and a "late recurrence group" of 56 patients (died two years or more after surgery). Clinicopathological characteristics were examined, and independent risk factors influencing the timing of recurrence were determined by a multiple logistic regression analysis.
  
  
  RESULTS
  The mean tumor size of early recurrence cases was larger than that of late recurrence cases (p=0.0294). Tumors penetrating the serosa with direct invasion to continuous structures were found more frequently in the early recurrence group than in the late recurrence group. The patients with early recurrence showed a higher tendency to have nodal involvement, lymphatic invasion and vascular invasion. The relative risks of early and late recurrences associated with different variables were estimated by a multiple logistic regression method. The following variables were found to be significant risk factors for early recurrence: male gender (p=0.0382), lymph node metastasis (p=0.0016), and vascular invasion (p=0.0006).
  
  
  CONCLUSIONS
  Male patients who have node-positive gastric cancer with vascular invasion have a high risk of early recurrence.
authors.affiliation: Department of Gastroenterological Surgery, Sendai National Hospital, Japan. yokota-t@snh.go.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Yokota
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Saito
authors.forename: Shin
authors.initials: S
authors.lastname: Teshima
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yamada
authors.forename: Kazutsugu
authors.initials: K
authors.lastname: Iwamoto
authors.forename: Michinori
authors.initials: M
authors.lastname: Takahashi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ishiyama
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Murata
authors.forename: Hidemi
authors.initials: H
authors.lastname: Yamauchi
mesh_terms: D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors