Risk Factors for Recurrence After Curative Conversion Surgery for Unresectable Gastric Cancer.
OBJECTIVE
To evaluate the recurrence risk after curative conversion surgery following chemotherapy for initially unresectable gastric cancer.


METHODS
We retrospectively analyzed clinicopathological and postoperative recurrence-free survival (RFS) data for 34 patients who underwent curative conversion surgery.


RESULTS
Recurrence was observed in 17 (50%) patients, with a median time to recurrence of 22 months (range=1-98 months). In nine (53%) patients with recurrence, the pattern was consistent with their initial metastatic disease. According to multivariate Cox regression analysis, initial clinical T4b disease (cT4b; odds ratio=6.44, 95% confidence interval=1.59-23.9; p=0.01) was the only significant independent risk factor affecting RFS. Pathological T4a or T4b disease was recorded in five-out of six (83%) patients with cT4b.


CONCLUSIONS
Initial cT4b disease appears to predict recurrence in patients with initially unresectable gastric cancer treated with curative conversion surgery. Effective use of additional chemotherapy may be required for patients with this risk factor.
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan mfukuchi@saitama-med.ac.jp.
Minoru
M
Fukuchi
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Toru
T
Ishiguro
Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
Kyoichi
K
Ogata
Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
Akiharu
A
Kimura
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Youichi
Y
Kumagai
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Keiichiro
K
Ishibashi
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Hideyuki
H
Ishida
Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Japan.
Hiroyuki
H
Kuwano
Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
Erito
E
Mochiki
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology*; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
Unresectable gastric cancer; conversion surgery; recurrence