title: Clinicopathologic study of node-negative advanced gastric cancer and analysis of factors predicting its recurrence and prognosis.
abstract: BACKGROUND
  This study aimed to reveal the predictors for the recurrence pattern of gastric cancer (GC) and analyze the prognostic factors in node-negative advanced (T2 to T4) GC after curative resection.
  
  
  METHODS
  Between 1994 and 2006, 448 patients with node-negative advanced GC undergoing radical resection were enrolled in this study. Clinicopathologic factors affecting the recurrence pattern and prognosis for GC were analyzed.
  
  
  RESULTS
  Location, size, tumor invasion depth, and perineural invasion were associated with tumor recurrence and outcome. T4 status was a predictor for locoregional recurrence and peritoneal seeding, and a large tumor size and the presence of perineural invasion predicted hematogenous spread. Patients with only locoregional recurrence had better survival than those with peritoneal seeding or hematogenous spread.
  
  
  CONCLUSIONS
  In node-negative advanced GC, the prognostic factor differed significantly between locoregional recurrence/peritoneal seeding and hematogenous metastasis. Survival rates were higher in patients with locoregional recurrence alone than in patients with other recurrence patterns.
authors.affiliation: Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Kweishan Shiang, Taoyuan, Taiwan.
authors.forename: Hsu-Huan
authors.initials: HH
authors.lastname: Chou
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Kuo
authors.forename: Jun-Te
authors.initials: JT
authors.lastname: Hsu
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Chen
authors.forename: Chun-Jun
authors.initials: CJ
authors.lastname: Lin
authors.forename: Jeng-Hwei
authors.initials: JH
authors.lastname: Tseng
authors.forename: Ta-Sen
authors.initials: TS
authors.lastname: Yeh
authors.forename: Tsann-Long
authors.initials: TL
authors.lastname: Hwang
authors.forename: Yi-Yin
authors.initials: YY
authors.lastname: Jan
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009366:Neoplasm Seeding; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*