title: Factors affecting recurrence in node-negative advanced gastric cancer.
abstract: OBJECTIVE
  Prognostic factors of lymph node-negative gastric adenocarcinoma after curative resection have been discussed. Recurrent pattern of advanced lymph node-negative gastric cancer after curative resection has rarely been described.
  
  
  METHODS
  Recurrent sites and correlated clinicopathological factors of 372 patients with lymph node-negative advanced gastric adenocarcinoma that underwent R0 resection from 1988 to 2005 were analyzed.
  
  
  RESULTS
  Recurrence was noted in 51 (13.7%) patients. Recurrent rates according to site of recurrence were 26 peritoneal seeding (51.0%), 26 locoregional (51.0%), 17 hematogenous (33.3%), and 4 lymph node metastasis (7.8%). Clinicopathological factors to predict peritoneal seeding were serosal exposure, lymphovascular invasion, Lauren's diffuse type differentiation and scirrhous stromal reaction. Serosal exposure, tumor size, microscopic infiltrating growth type predicts locoregional recurrence. Tumor had only lymphovascular invasion predict hematogenous spreading.
  
  
  CONCLUSIONS
  Node-negative advanced gastric cancer has more peritoneal seeding and locoregional recurrence. Aggressive cell behavior predicted the route of tumor cell spreading.
authors.affiliation: Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan.
authors.forename: Kuo-Hung
authors.initials: KH
authors.lastname: Huang
authors.forename: Jen-Hao
authors.initials: JH
authors.lastname: Chen
authors.forename: Chew-Wun
authors.initials: CW
authors.lastname: Wu
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
authors.forename: Mao-Chih
authors.initials: MC
authors.lastname: Hsieh
authors.forename: Anna F-Y
authors.initials: AF
authors.lastname: Li
authors.forename: Win-Yiu
authors.initials: WY
authors.lastname: Lui
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000368:Aged; D005260:Female; D005743:Gastrectomy; D019337:Hematologic Neoplasms / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome