title: Clinicopathological analysis for recurrence of stage Ib gastric cancer (according to the second English edition of the Japanese classification of gastric carcinoma).
abstract: BACKGROUND
  The prognosis for patients with stage Ib (second English edition of the Japanese classification of gastric carcinoma) gastric cancer is promising, with an expected 5-year survival of 90%. Despite this relatively high survival rate, the outcome for patients who experience recurrence is poor. To date, however, prognostic and recurrence factors for stage Ib gastric cancer are poorly understood, and appropriate adjuvant chemotherapy protocols have not been developed.
  
  
  METHODS
  We retrospectively analyzed data from 86 stage Ib gastric cancer patients who underwent curative gastrectomy to determine the rates and predictive factors of recurrence.
  
  
  RESULTS
  Eleven patients showed recurrence, with a 12.8% 5-year cumulative recurrence rate. Nearly all of these patients were initially histologically diagnosed with poorly differentiated adenocarcinoma. Based on univariate analyses, recurrence was associated with gender and histological type. Multivariate analyses revealed that the only independent risk factor for recurrence was histologically undifferentiated-type adenocarcinoma. The 5-year survival rate of patients with undifferentiated-type adenocarcinoma was 84%. The predominant recurrence pattern was peritoneal dissemination, and was typically observed 1-3 years post-resection.
  
  
  CONCLUSIONS
  This retrospective study identified undifferentiated-type adenocarcinoma as the only risk factor for recurrence in stage Ib gastric cancer patients. Although randomized controlled studies are necessary, stage Ib gastric cancer patients with this identified recurrence risk factor would be candidates for adjuvant chemotherapy.
authors: Department of Surgery, Hoshigaoka Kouseinenkin Hospital, 4-8-1 Hoshigaoka, Hirakata, Osaka, Japan. yokoyamatakashi1@yahoo.co.jp
authors: Takashi
authors: T
authors: Yokoyama
authors: Kiyoshi
authors: K
authors: Kamada
authors: Yoshikazu
authors: Y
authors: Tsurui
authors: Hisanori
authors: H
authors: Kashizuka
authors: Eiji
authors: E
authors: Okano
authors: Sanehito
authors: S
authors: Ogawa
authors: Shinsaku
authors: S
authors: Obara
authors: Mitsutoshi
authors: M
authors: Tatsumi
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