Incidence and Factors Associated with Recurrence Patterns after Intended Curative Surgery for Gastric Cancer

Wu, Chew Wun; Lo, Su Shun; Shen, King Han; Hsieh, Mao Chih; Chen, Jen-Hao; Chiang, Jen–Huey; Lin, Hwai Jeng; Li, Anna F.Y.; Lui, Wing Yiu

doi:10.1007/s00268-002-6279-7

Cited by 139 publications

(81 citation statements)

References 31 publications

(49 reference statements)

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“…In a study by Wu et al . (11), cumulative recurrence rates were 53.5%, 80.0%, 89.0%, 94.7%, 96.3%, 98.0%, and 99.5% at 1, 2, 3, 4, 5, 6, and 7 years, respectively. Lee et al .…”

Section: Discussionmentioning

confidence: 88%

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

Shin

Lee

Hong

et al. 2016

Chinese Journal of Cancer Research

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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.

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“…In a study by Wu et al . (11), cumulative recurrence rates were 53.5%, 80.0%, 89.0%, 94.7%, 96.3%, 98.0%, and 99.5% at 1, 2, 3, 4, 5, 6, and 7 years, respectively. Lee et al .…”

Section: Discussionmentioning

confidence: 88%

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

Shin

Lee

Hong

et al. 2016

Chinese Journal of Cancer Research

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“…The incidence of distant metastasis was comparably high (30–45%) all over the world [3, 5, 7, 8, 10–12, 17, 18]. Patients in Japan and South Korea suffered lower local-regional recurrence compared with China (7-10 vs. 32.4%) [7–9].…”

Section: Discussionmentioning

confidence: 99%

The patterns and timing of recurrence after curative resection for gastric cancer in China

Liu

et al. 2016

World J Surg Onc

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BackgroundThe recurrence of gastric cancer after curative resection had adverse effects on patients’ survival. The treatment presence varied from different countries. The aims of this study were to understand the recurrence incidence, patterns, and timing and to explore the risk factors in China.MethodsOne thousand three hundred four patients who undergoing curative resection from more than 100 hospitals between January 1st 1986 and September 1st 2013, were surveyed in detail. Clinical pathological factors were examined as potential risk factors of each recurrence pattern using univariate and multivariate analyses. Recurrence timing was also analyzed based on disease-free survival.ResultsAmong 1304 gastric cancer patients, 793 patients (60.8%) experienced recurrence and 554 patients (42.5%) experienced recurrence within 2 years after operation. The median disease-free survival was 29.00 months (interquartile range [IQR] 12.07, 147.23). Receiving operation in general hospitals was one of independent risk factors of local-regional recurrence (OR = 1.724, 95% CI 1.312 to 2.265) and distant metastasis (OR = 1.496, 95% CI 1.164 to 1.940). Patients would suffer lower risk of distant metastasis if they received no more than 3 cycles adjuvant chemotherapy (OR = 0.640, 95% CI 0.433 to 0.943). Adjuvant radiotherapy could reduce the risk of recurrence (OR 0.259, 95% CI 0.100 to 0.670), especially distant metastasis (OR = 0.260, 95% CI 0.083 to 0.816).ConclusionsMore than 60% patients experienced recurrence after curative resection for gastric cancer, especially within 2 years after surgery. Risk factors were clarified between various recurrence patterns. Advanced gastric cancer and undergoing operation in general hospitals contributed to increased recurrence risk and worse survival. Enough number of lymph nodes harvest and standard D2 lymphadenectomy could reduce recurrence. Chinese patients would benefit from adjuvant chemotherapy and radiotherapy.

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“…Locoregional recurrence occurs most commonly at the anastomosis site or stump [6]. An isolated locoregional recurrence was reported in 6% to 46% of patients who underwent surgical resection [4,6,9,11,12]. Locoregional recurrence results from direct tumor proliferation or lymphatic spread within the abdominal cavity [13].…”

Section: Discussionmentioning

confidence: 99%

“…More than 90% of patients relapse within five years after surgery, and 70% relapse within two years. Wu et al [4] reported that cumulative recurrence rates were 53.5%, 80.0%, 89.0%, 94.7%, and 96.3% at 1, 2, 3, 4, and 5 years, respectively. These high rates of recurrence have been attributed to abundant lymphatic channels within the gastric wall that provide channels for mucosal skip lesions and numerous potential pathways of lymphatic drainage away from the stomach.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Anastomotic Recurrence after Gastrectomy for Gastric Cancer

Jung

Cho

Shin

et al. 2014

Korean J Thorac Cardiovasc Surg

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BackgroundThe purpose of this study was to evaluate the outcome of reoperation with curative intent for the treatment of anastomotic recurrent gastric cancer.MethodsTen patients with anastomotic recurrence of gastric cancer who underwent reoperation from November 1995 to February 2011 were analyzed retrospectively. The time interval between the first operation and reoperation, recurrence pattern, type of surgery, survival, and postoperative outcome were analyzed.ResultsThe average time to recurrence after initial surgery was 48.8 months (median, 23.5 months). Of the ten patients, eight (80.0%) had recurrence at the esophagojejunostomy, one (10.0 %) at the esophagogastrostomy, and two (20.0%) at the esophagus. Among these patients, five had combined metastasis or invasion to major organs in addition to anastomotic recurrence. Complete resection was achieved in five patients (50.0%), and incomplete resection or bypass surgery was performed in the remaining five patients (50.0%). The overall median survival time was 7.0 months (range, 2.2 to 105.5 months). The median survival time following complete resection and palliative surgery (incomplete resection or bypass surgery) was 28.1 months (range, 4.2 to 105.5 months) and 5.5 months (range, 2.2 to 7.5 months), respectively.ConclusionSurgical resection of anastomotic recurrent gastric cancer should be implemented only in selected patients in whom complete resection is possible.

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Incidence and Factors Associated with Recurrence Patterns after Intended Curative Surgery for Gastric Cancer

Cited by 139 publications

References 31 publications

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

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

The patterns and timing of recurrence after curative resection for gastric cancer in China

Surgical Treatment of Anastomotic Recurrence after Gastrectomy for Gastric Cancer

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