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KMID : 0371320000590060765
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Journal of the Korean Surgical Society
2000 Volume.59 No. 6 p.765 ~ p.770
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The Patterns of Recurrence after Curative Resection in Gastric Cancer
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Chung Ho-Young
Yu Wan-Sik
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Abstract
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Purpose :Recurrence of gastric cancer is not infrequent even though the surgery was curative. The main purpose of this study was to evaluate the relationships between the clinicopathological factors and the recurrence patterns to develop the strategies for the adjuvant treatment.
Methods :We followed the postoperative courses of 578 patients with gastric cancer who underwent curative surgery at the Department of Surgery, Kyungpook National University Hospital from 1990 to 1994.
Results :One hundred and forty patients (24.2%) died of a recurrence of the gastric cancer, and 40 (6.9%) died without recurrent disease. The most frequent mode of recurrence was peritoneal seeding (40.0%), followed by hematogenous recurrence (29.2%) and local recurrence (25.0%). The incidence of peritoneal recurrence was significantly higher in subgroups of patients with serosal invasion (47.2% and 17.2%; p=0.011) and with poorly differentiated tumors (47.4% and 27.3%; p=0.002). The incidence of hematogenous recurrence was significantly higher in subgroups of patients without serosal invasion (41.4% and 25.3%; p=0.011) and with well or moderately differentiated tumors (47.7% and 18.4%; p=0.002). The recurrence rates according to the lymph node dissection and postoperative systemic chemotherapy were not significantly different.
Conclusion :In patients with serosal invasion or with poorly differentiated tumors, an effort to prevent peritoneal recurrence is needed. And in patients with well or moderately differentiated tumors, an effort to prevent hematogenous recurrence is also needed.
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KEYWORD
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Stomach neoplasm, Gastrectomy, Recurrence pattern, Adjuvant therapy,
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