Management strategies for locoregional recurrence in early-stage gastric cancer: retrospective analysis and comprehensive literature review.
OBJECTIVE
To present a comprehensive account and literature review addressing the anatomical distribution, natural history, and management strategies for locoregional recurrence in early-stage gastric cancer (EGC).


METHODS
Retrospective chart review of patients presenting with EGC recurrence at King Hussein Cancer Center (Amman, Jordan) between July 2006 and May 2009. A literature review of publications addressing recurrence following surgery for EGC was undertaken via a systematic search of PUBMED database and National Comprehensive Cancer Network (NCCN) guideline updates.


RESULTS
Seventeen patients presented with EGC, three of whom (17.6%) were pathologically staged as T2N1 [1/33 lymph nodes (LNs)], T1N0, and T1N0 were afflicted by recurrence following R0 partial gastrectomy. Literature review yielded 18 studies specifically addressing recurrence in EGC. Several management strategies have been proposed for isolated recurrence following gastrectomy in EGC. NCCN clinical practice guideline updates do not take into consideration whether the recurrence is isolated or widespread and whether the initial stage is early or advanced.


CONCLUSIONS
While acknowledging the limitations of this study, including the small sample size and the short follow-up period, it appears clear that oncologic treatment is possible for EGC recurrence, particularly, in patients with isolated relapse. Guideline updates should differentiate between management strategies suitable for recurrence occurring in early versus advanced initial cancer stage.
Salem
Ahmed
A
Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan.
Hashem
Sameh
S
Mula-Hussain
Layth Y I
LY
Mohammed
Issa
I
Nour
Ala'a
A
Shelpai
Wael
W
Daoud
Faiez
F
Morcos
Basem
B
Yamin
Yasser
Y
Jaradat
Imad
I
Khader
Jamal
J
Almousa
Abdelatief
A
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*