Clinicopathological analysis for recurrence of early gastric cancer.
BACKGROUND
Although the prognosis of early gastric cancer (EGC) is considered to be satisfactory, some patients experience disease recurrence after curative resection. This study was aimed at evaluating the recurrence rate, the recurrence patterns and the prognostic factors for recurrence of EGC as well as treatment results after recurrences.


METHODS
We investigated follow-up records of 1452 EGC patients on whom curative operations were performed at Seoul National University Hospital from 1986 to 1995 with special reference to cancer recurrence.


RESULTS
Twenty-one patients showed recurrences with a 1.5% 5-year cumulative recurrence rate. Four cases were locoregional recurrences, two were peritoneal recurrences, nine were distant recurrences and six were mixed type recurrences. The 5-year survival rates of T1N0, T1N1, T1N2 and T1N3 were 99.3, 96.8, 72.7 and 0%, respectively (P < 0.001). Multivariate analysis revealed a significantly high correlation between positive lymph node metastasis and recurrence (P < 0.001). Median survival after recurrence of EGC was 4.3 months. Median survival after recurrence was 5.8 months after chemotherapy and 3.1 months after conservative management (P = 0.69).


CONCLUSIONS
Although the recurrence of EGC is very rare in general, EGC with lymph node metastasis has a higher possibility of recurring, especially with >6 positive lymph nodes. Even after curative resection of EGC, patients with EGC with >6 positive lymph nodes should be closely followed and be considered as candidates for adjuvant treatment.
Lee
Hyuk-Joon
HJ
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Kim
Yoon Ho
YH
Kim
Woo Ho
WH
Lee
Kuhn Uk
KU
Choe
Kuk Jin
KJ
Kim
Jin-Pok
JP
Yang
Han-Kwang
HK
D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery