title: The pattern and risk factors of recurrence of proximal gastric cancer after curative resection.
abstract: OBJECTIVE
  To explore the time and pattern of recurrence of proximal gastric cancer and estimate the risk factors and prognostic factors for it. Considering these risk factors, postoperative adjuvant therapies and follow-up program can be individualized.
  
  
  METHODS
  The data of 135 recurrence proximal gastric cancer patients were extracted and analyzed.
  
  
  RESULTS
  In 135 recurrence patients, the median time to recurrence was 14.0 months, 116 (85.9%) patients had recurrences within 2 years. Loco-regional recurrence was the most prevalent pattern. Hematogenous metastasis was next prevalent pattern in which the liver was the most common organ. Peritoneal recurrence occurred in 32 patients. Five patients recurred in distant lymph nodes. The deeper invasion was associated with higher incidence of hematogenous metastases and peritoneal recurrence. The histological type, depth of invasion, and lymph node metastasis were independent risk factors for overall recurrence. While, negative lymph nodes counts were another independent risk factors for early recurrence. Patients with systemic recurrence and early recurrence patients had poorer prognosis.
  
  
  CONCLUSIONS
  Total gastrectomy and adequate lymph nodes dissection were rational choice of proximal gastric cancer with deeper invasion. Pathologic predictors of invasion, histological type, lymph nodes metastasis and negative lymph node counts could guide individualized, risk-oriented adjuvant treatment, and follow-up plan.
authors.affiliation: Department of Gastric Cancer Surgery, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China.
authors.forename: Fangxuan
authors.initials: F
authors.lastname: Li
authors.forename: Rupeng
authors.initials: R
authors.lastname: Zhang
authors.forename: Han
authors.initials: H
authors.lastname: Liang
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Jichuan
authors.initials: J
authors.lastname: Quan
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000556:secondary*; D016015:Logistic Models; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000556:secondary*; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors