title: Risk factors for recurrence in T1-2N0 gastric cancer in the United States and China.
abstract: BACKGROUND
  Recurrence patterns after curative intent gastrectomy for T1-2N0 gastric adenocarcinoma are poorly defined. We sought to assess timing, patterns, and risk factors for recurrence in patients treated at two high-volume gastric cancer centers in the United States and China.
  
  
  METHODS
  Between 1995 and 2011, 1,058 patients underwent curative intent gastrectomy. Recurrences were classified as locoregional, distant, or peritoneal. Univariate and multivariate analyses were performed to identify risk factors for recurrence.
  
  
  RESULTS
  Overall, 7% (76) of our 1,058 patients from the United States (n = 414) and China (n = 644) recurred. Liver (43%) was the most common site of recurrence in both countries (US: 24%, China: 52%), followed by peritoneum (16%), lymph nodes (10%), and anastomosis (8%). Median time to recurrence was 23 months (US: 30 months, China: 23 months), which decreased with increasing T-stage (T1a: 27 months, T1b: 24 months, T2: 22 months). Tumor size (P = 0.001), depth of invasion (P = 0.010), histological type (P = 0.022) and lymphovascular invasion (P = 0.001) were independently associated with recurrence.
  
  
  CONCLUSIONS
  Patients infrequently recur following curative intent gastrectomy for T1-2N0 gastric adenocarcinoma. Almost all recurrences occur between six months and 3 years post-operatively, most frequently in distant anatomic locations; selective followup during this time period is recommended. J. Surg. Oncol. 2016;113:745-749. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Cao
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, New York.
authors.forename: Luke V
authors.initials: LV
authors.lastname: Selby
authors.affiliation: Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York City, New York.
authors.forename: Yelena Y
authors.initials: YY
authors.lastname: Janjigian
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York City, New York.
authors.forename: Laura
authors.initials: L
authors.lastname: Tang
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, New York.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Coit
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, New York.
authors.forename: Murray F
authors.initials: MF
authors.lastname: Brennan
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York City, New York.
authors.forename: Vivian E
authors.initials: VE
authors.lastname: Strong
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000209:etiology / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000209:etiology / Q000556:secondary*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: China and the US; Eastern and Western; gastric cancer; gastric carcinoma; post-operative follow up; prognosis; recurrence pattern