Factors Predicting Timing of Recurrence after Radical Gastrectomy for Gastric Carcinoma

ABSTRACT

PURPOSE: TNM classification accurately predicts overall survival but not risk of recurrence. This study analyzed patients who died of recurrent gastric carcinoma and attempteded to clarify clinicopathological factors associated with time of recurrence. METHODS: A retrospective review of 526 patients with gastric cancer, radically treated between 1988~1997 was performed. Multivariate analysis of differences between 116 patients with early recurrence (2 years after gastrectomy). RESULTS: Compared with the late recurrence group, the early recurrence group was characterized by larger tumor size (84.2 vs. 65.9 mm), serosal invasion (94 vs. 75.6%), infiltration into the esophagus or duodenum (44.0 vs. 22.0%). On multivariate analysis, time of recurrence was independently associated with status of serosal invasion only. CONCLUSION: Serosal invasion is the single most important factor to predict time of recurrence. Patients with serosal invasion frequently suffered from recurrence within 2 years after radical gastrectomy. From our conclusion, we propose to exclude T3-4 cancers from the current inclusion criteria of radical gastrectomy.