Characteristics of gastric cancer recurrence five or more years after curative gastrectomy

Abstract

ObjectiveTo investigate the characteristics of recurrences that occurred 5 or more years after curative resection for gastric cancer.MethodsWe analyzed recurrences among 1,299 patients with gastric cancer who underwent curative operations at the Department of Surgery, Inje University Seoul Paik Hospital between September 1998 and December 2002. Recurrences were classified as within 2 years (early), 2–5 years (intermediate), and more than 5 years (late) after gastrectomy. The clinicopathologic findings of the patients with late recurrence were compared with those of patients in the other two recurrence groups, with special reference to the patterns of recurrence. Both univariate and multivariate analyses were performed, incorporating factors such as operation type, T-stage, N-stage, stage, lymphatic invasion, neural invasion, histology, tumor size, and recurrence site.ResultsAt the time of last follow-up, recurrence occurred in 266 (20.5%) patients. Recurrence times were classified as <2 years (182 patients), 2–5 years (61 patients), or >5 years (23 patients). The late recurrence rate was 8.6%. The occurrence of recurrence >5 years after gastrectomy was significantly correlated with age, operation type, T-stage, N-stage, stage, lymphatic invasion, neural invasion, histology, tumor size, location and recurrence site (P<0.05). The main recurrence patterns in the 23 patients with late recurrence were locoregional metastasis (10 patients, 43.5%), peritoneal seeding (8 patients, 34.8%), hematogenous metastasis (2 patients, 8.7%), and multiple metastasis (3 patients, 13.0%). A multivariate analysis showed that larger tumor size and younger age were independent prognostic factors for late recurrence. Additionally, locoregional and peritoneal recurrences were significantly more common than hematogenous recurrences.ConclusionsAlthough late recurrence was uncommon, younger age and larger tumor size were associated with high risk. Follow-up surveillance is recommended for locoregional and peritoneal metastasis.

Adapting and Surviving: Intra and Extra-Cellular Remodeling in Drug-Resistant Gastric Cancer Cells

“…Several chemotherapeutic strategies have been used in patients with unresectable tumors to relieve symptoms and decrease the risk of recurrence [7] and metastasis [8,9], with a 5-year overall survival of 20–35% [10,11]. Moreover, compared with surgery alone, perioperative chemotherapy is able to significantly improve prognosis of patients with resectable GC [12,13].…”

The Risk of Developing Multiple Primary Cancers among Long-Term Survivors Five Years or More after Stomach Carcinoma Resection

“…In this study, among the 3,061 five-year survivors, recurrent stomach carcinoma was newly diagnosed in only 27 patients (0.9%), representing 1.7% of the 1,569 patients with a diagnosis of recurrent stomach carcinoma. The rate of the late recurrence of ≥ 5 years and of ≥ 10 years diagnosed after surgery was reported to be 7.1%-8.6% and 1.1%-1.4% respectively, among all patients with a recurrent stomach carcinoma (Lee et al 2016;Shin et al 2016).…”

Germline mutations in hereditary diffuse gastric cancer

“…However, multiple foci of early-stage carcinoma were found in her gastrectomy specimen. In another case, a 43year-old female accepted genetic counseling and prophylactic total gastrectomy after the death of her brother and nephew (56). Although no evidence of dysplasia or early foci of SRCC was seen in 30 biopsies and 68 postoperative blocks, "prevention is better than cure" was the common consensus and final decision of both patients and families.…”