Predictors of timing and patterns of recurrence after curative resection for gastric cancer.
OBJECTIVE
The aim of the study was to characterize recurrence patterns and identify predictors of recurrence after curative resection.


METHODS
Of 2,786 patients that underwent curative resection for gastric cancer from 2001 to 2006 at the Korean National Cancer Center, 439 (15.8%) experienced recurrence. Patterns of recurrence, clinicopathological characteristics, and therapeutic modalities were compared between 251 patients who had recurrence within 1 year (the early recurrence group) and 188 patients who had recurrence after more than a year (the late recurrence group). Multivariate analysis was performed to identify independent factors associated with the timing of recurrence.


RESULTS
In the early recurrence group, the most common pattern was hematogenous metastasis, and in the late recurrence group, the most common pattern was locoregional and peritoneal recurrence. The early recurrence group was characterized by a larger tumor, frequent lymph node (LN) metastasis, and venous, and perineural invasion. Multivariate analysis showed that LN metastasis and venous invasion were independent predictors of early recurrence. Median survival after recurrence was significantly shorter in the early recurrence group (p < 0.001).


CONCLUSIONS
Hematogeneous metastasis was more common in the early recurrence group and LN metastasis and venous invasion were independent predictors of the timing of recurrence.
Center for Gastric Cancer, National Cancer Center, Gyeonggi-Do, South Korea.
Bang Wool
BW
Eom
Hongman
H
Yoon
Keun Won
KW
Ryu
Jun Ho
JH
Lee
Soo Jeong
SJ
Cho
Jong Yeul
JY
Lee
Chan Gyoo
CG
Kim
Il Ju
IJ
Choi
Jong Seok
JS
Lee
Myung Cherl
MC
Kook
Sook Ryun
SR
Park
Byung-Ho
BH
Nam
Young-Woo
YW
Kim
D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D009360:Neoplastic Cells, Circulating; D010534:Peritoneal Neoplasms / Q000556:secondary; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors