Kang WM, Meng QB, Yu JC, Ma ZQ, Li ZT. Factors associated with early recurrence after curative surgery for gastric cancer. World J Gastroenterol 2015; 21(19): 5934-5940 [PMID: 26019458 DOI: 10.3748/wjg.v21.i19.5934]
Corresponding Author of This Article
Jian-Chun Yu, MD, Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dongcheng District, Beijing 100730, China. yu-jch@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 21, 2015; 21(19): 5934-5940 Published online May 21, 2015. doi: 10.3748/wjg.v21.i19.5934
Table 1 Initial recurrence patterns in the 194 patients with recurrence n (%)
Pattern
Total recurrence
Early recurrence
Late recurrence
P value
n = 194 (100.0)
n = 129 (66.5)
n = 65 (33.5)
Hematogenous recurrence
77 (39.7)
56 (43.4)
21 (32.3)
0.136
Liver
55 (28.4)
42 (32.6)
13 (20.0)
0.067
Lung
16 (8.2)
10 (7.8)
6 (9.2)
0.724
Bone
14 (7.2)
8 (6.2)
6 (9.2)
0.442
Brain
3 (1.5)
2 (1.6)
1 (1.5)
0.995
Locoregional recurrence
99 (51.0)
68 (52.7)
31 (47.7)
0.509
Remnant stomach
10 (5.2)
6 (4.7)
4 (6.2)
0.734
Anastomosis
32 (16.5)
25 (19.4)
7 (10.8)
0.127
Perigastric area
40 (20.6)
27 (20.9)
13 (20.0)
0.880
Peripancreatic area
13 (6.7)
10 (7.8)
3 (4.6)
0.410
Abdominal wall
2 (1.6)
2 (1.9)
0 (0.0)
0.313
Local lymph node
34 (17.5)
27 (20.9)
7 (10.8)
0.079
Peritoneal recurrence
86 (44.3)
59 (45.7)
27 (41.5)
0.579
Distant lymphatic recurrence
11 (5.7)
7 (5.4)
4 (6.2)
1.000
Virchow’s node
6 (3.1)
4 (3.1)
2 (3.1)
1.000
Inguinal lymph node
1 (0.5)
0 (0.0)
1 (1.5)
0.335
Mediastinal lymph node
3 (1.5)
2 (1.6)
1 (1.5)
1.000
Para-aortic lymph node
2 (1.0)
2 (1.6)
0 (0.0)
0.552
Table 2 Univariate analysis of factors predicting early recurrence in patients with early gastric cancer n (%)
Variable
Early recurrence
Late/no recurrence
Univariate analysis
n = 4
n = 76
P value
Gender
0.623
Women
1 (25.0)
35 (46.1)
Men
3 (75.0)
41 (53.9)
Age at diagnosis (yr)
0.646
≤ 60
3 (75.0)
45 (59.2)
60
1 (25.0)
31 (40.8)
Tumor size (cm)
0.011
≤ 5.0
2 (50.0)
74 (97.4)
>5.0
2 (50.0)
2 (2.6)
Lauren histotype
0.646
Intestinal
3 (75.0)
45 (59.2)
Diffuse-mixed
1 (25.0)
31 (40.8)
Lymphovascular invasion
< 0.144
Present
1 (25.0)
2 (2.6)
Absent
3 (75.0)
74 (97.4)
pT stage
< 0.639
pT1a
2 (50.0)
47 (61.8)
pT1b
2 (50.0)
29 (38.2)
pN stage
0.048
N0
2 (50.0)
70 (92.1)
N1, N2
2 (50.0)
6 (7.9)
Intraoperative chemotherapy
1.000
Yes
1 (25.0)
19 (25.0)
No
3 (75.0)
57 (75.0)
Table 3 Univariate analysis of factors predicting early recurrence in patients with locally advanced gastric cancer n (%)
Variable
Early recurrence
Late/no recurrence
Univariate analysis
n = 125
n = 212
P value
Gender
0.683
Women
41 (32.8)
65 (30.7)
Men
84 (67.2)
147 (69.3)
Age at diagnosis (yr)
0.016
≤ 60
52 (41.6)
117 (55.2)
> 60
73 (58.4)
95 (44.8)
Tumor size (cm)
0.019
≤ 5.0
76 (60.8)
155 (73.1)
> 5.0
49 (392)
57 (26.9)
Lauren histotype
0.016
Intestinal
85 (68.0)
169 (79.7)
Diffuse-mixed
40 (32.0)
43 (20.3)
Lymphovascular invasion
< 0.001
Present
21 (16.8)
9 (4.2)
Absent
104 (83.2)
203 (95.8)
pT stage
< 0.001
pT2, pT3
30 (24.0)
105 (49.5)
pT4a
95 (76.0)
107 (50.5)
pN stage
< 0.001
N0
13 (10.4)
82 (38.7)
N1
25 (20.0)
52 (24.5)
N2
30 (24.0)
46 (21.7)
N3
57 (45.6)
32 (15.1)
Intraoperative chemotherapy
< 0.001
Yes
54 (43.2)
136 (64.2)
No
71 (56.8)
76 (35.8)
Postoperative chemotherapy
0.036
No
42 (33.6)
49 (23.1)
5-FU-based regimen
83 (66.4)
163 (76.9)
Table 4 Multivariate analysis of factors predicting early recurrence by binary logistic regression model
Factor
P value
OR
95%CI
A Age at diagnosis
0.033
1.813
1.050-3.131
pT pT stage
< 0.001
2.865
1.603-5.123
pN stage
< 0.001
N0
1.00 (reference)
N1
0.001
4.029
1.708-9.500
N2
0.001
4.425
1.889-10.365
N3
< 0.001
9.860
4.314-22.536
Lauren histotype
< 0.001
3.492
1.810-6.736
Lymphovascular invasion
0.011
3.460
1.335-8.969
Intraoperative chemotherapy
< 0.001
0.327
0.190-0.564
Postoperative chemotherapy
0.007
0.423
0.225-0.793
Citation: Kang WM, Meng QB, Yu JC, Ma ZQ, Li ZT. Factors associated with early recurrence after curative surgery for gastric cancer. World J Gastroenterol 2015; 21(19): 5934-5940