Surgical treatment of recurrent gastric cancer.
BACKGROUND
The value of programs to detect recurrence of a previously operated gastric cancer is a controversial subject. D2 lymphadenectomy achieves better local control and a lower local recurrence rate than D1 lymphadenectomy.


METHODS
The results achieved with surgical treatment of recurrent gastric cancer in a series of 126 consecutive patients who had been treated with gastrectomy with D2 lymphadenectomy are reported. In-hospital mortality was 1.6%.


RESULTS
Follow-up of the remaining 124 patients for a median period of 73.6 months detected recurrence in 46 patients (37%). There were 14 local, 12 peritoneal, and 15 distant recurrences. Recurrent gastric cancer was detected within 2 years in 76% of the patients. Of the 46 patients with recurrence, 5 patients (11%) were selected for surgery (4 local and 1 peritoneal recurrence). The median disease-free time after surgery for recurrence was 26 months (range, 14-58 months). There was no in-hospital mortality. The median survival time after surgery for recurrence was 26 months (range, 9-87 months). One patient died during follow-up, while none of the other patients have any evidence of new recurrence.


CONCLUSIONS
Surgery for recurrent gastric cancer is a valid alternative in selected patients, provided it is performed by specialized work teams.
de Liaño
Alvaro Díaz
AD
Esophagogastric Unit, Department of General and Gastrointestinal Surgery, Hospital Virgen del Camino, Pamplona, Navarra, Spain.
Yarnoz
Concepción
C
Aguilar
Rubén
R
Artieda
Cristina
C
Ortiz
Héctor
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome