title: Locoregional relapse after gastrectomy with D2 lymphadenectomy for gastric cancer.
abstract: BACKGROUND
  Risk for and site of locoregional relapse have not been well studied in patients undergoing gastrectomy with D2 lymphadenectomy for gastric cancer.
  
  
  METHODS
  Patients who had undergone gastrectomy with D2 lymphadenectomy for gastric cancer between 2004 and 2007 were identified from an institutional database. The locoregional relapse rate was estimated by competing risk analysis, and risk groups were derived according to locoregional relapse risk using recursive partitioning analysis (RPA). The locations of nodal relapses were evaluated according to Japanese Classification of Gastric Carcinoma criteria.
  
  
  RESULTS
  Some 2618 patients were included. With a median follow-up of 78·0 (range 28·5-122·6) months, relapse was diagnosed in 471 of 2618 patients (18·0 per cent). The cumulative incidence of locoregional relapse at 5 years was 8·5 (95 per cent c.i. 7·4 to 9·6) per cent. The 5-year locoregional recurrence rates for high-risk (N3), intermediate-risk (N1-2) and low-risk (N0) groups were 32·4, 12·3 and 1·7 per cent respectively (P < 0·001). Among patients with regional relapse, 90·4 per cent had involvement outside the D2 dissected area, and the most commonly involved site was station 16b1. This pattern was maintained in the RPA risk groups (P = 0·329).
  
  
  CONCLUSIONS
  Locoregional relapse at 5 years after gastrectomy with D2 lymphadenectomy was 8·5 per cent, and was most often seen outside the D2 dissected area.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Chang
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H I
authors.initials: HI
authors.lastname: Yoon
authors.affiliation: Department of Surgery, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: W J
authors.initials: WJ
authors.lastname: Hyung
authors.affiliation: Division of Medical Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Rha
authors.affiliation: Division of Medical Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Y C
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Department of Radiology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: J S
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Surgery, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Noh
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Centre, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: W S
authors.initials: WS
authors.lastname: Koom
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate