title: Bone recurrence after curative resection of gastric cancer.
abstract: BACKGROUND
  Standard follow up for bone recurrence has not yet been established for gastric cancer after surgical resection. The aim of this study was to investigate the incidence of and related risk factors for bone recurrence after surgical resection of gastric cancer.
  
  
  METHODS
  A cohort of 3035 gastric cancer patients after curative resection was reviewed. We analyzed the patients who had bone scintigraphy before the surgery as well as during the follow-up period. The incidence of and the risk factors for bone recurrence after surgical resection of gastric cancer were investigated.
  
  
  RESULTS
  In a total of 1683 patients analyzed, bone recurrence was detected in 30 patients (1.8%). The incidence of bone recurrence was significantly higher in advanced gastric cancers than in early lesions (3.5 vs. 0.4%, p < 0.01). The most common recurrence site was the spine, followed by pelvic bone and rib. Most patients had multiple bone metastases. The median time for recurrence was 28 months (range 4-111) from the surgery. In univariate analysis, the recurrence rate was higher in the tumors with large size, undifferentiated pathology, location in the body, and advanced stage. In multivariate analysis, lymph node metastasis (N2/N3 vs. N0/N0I) was the most predictable risk factor for bone recurrence [hazard ratio [HR] 1.44 (95% confidence interval [CI] 1.217-1.694)] and depth of invasion (T2-4 vs. T1) was also independently associated with bone recurrence.
  
  
  CONCLUSIONS
  The incidence of bone recurrence was low after curative surgery in patients with gastric cancer. Intensive follow up with bone scintigraphy seems to be unnecessary in these patients.
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, # 505, Banpo-Dong, Seocho-Gu, Seoul, 137-701, Korea. parkjerry@catholic.ac.kr
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Park
authors.forename: Kyo Young
authors.initials: KY
authors.lastname: Song
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: O
authors.forename: Won Chul
authors.initials: WC
authors.lastname: Kim
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.forename: Cho Hyun
authors.initials: CH
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D015994:Incidence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D055815:Young Adult