Open Access, Peer-reviewed
pISSN 2288-6575
eISSN 2288-6796
    J Korean Surg Soc. 2010 Jul;79(1):35-42. Korean.
    Published online Jun 25, 2010.
    https://doi.org/10.4174/jkss.2010.79.1.35
    Copyright © 2010 The Korean Surgical Society
    Original Article

    Clinicopathological Analysis of Recurrence in Stage 1 Gastric Cancer

    Sang Hyun Baik, M.D., Song I Yang, M.D. and Yeon Myeong Shin, M.D.
      • Department of General Surgery, Kosin University College of Medicine, Busan, Korea.
    • Corresponding author (Email: sym@ns.kosinmed.or.kr )
    Received December 17, 2009; Accepted March 30, 2010.

    Abstract

    Purpose

    Recently, diagnosis of stage 1 gastric cancer has increased in number and prognosis is excellent when proper treatment is done. However, some patients have recurrence and their prognosis is poor. Thus, we investigated the risk factors of recurrence in stage 1 gastric cancer patients.

    Methods

    From January 2004 to December 2008, a total of 1,241 number patients were operated on for stage 1 gastric cancer at the Department of General Surgery, Kosin University Gospel Hospital. We reviewed the characteristics of all patients retrospectively and compared them to recurred group (n=24) and non-recurred group (n=1,114). We analyzed the risk factors associated with recurrence.

    Results

    Twenty-four patients with stage 1 gastric cancer were recurred after radical gastrectomy. Recurrence rate was 2.05%. The most common pattern of recurrence was hematogenous (41.7%), and lymphatic (20.8%), peritoneal seeding (16.7%), combined form (12.5%), and locoregional (8.3%). Five-year survival rate was 50.08% of recurrence group. Of clinicopathological factors, depth of invasion, lymph node metastasis, lymphatic involvement and tumor marker were statistically significant between recurred and other group.

    Conclusion

    In this study, tumor marker, tumor depth, node status, lymphatic channel involvement were possible risk factors of recurrence for stage 1 gastric cancer. More intensive follow up and care is needed for those with such risk factors.

    Keywords
    Stage 1 gastric cancer; Recurrence; Risk factor

    Figures

    Fig. 1
    Survival curves of recur and non-recur group.

    Fig. 2
    Survival curves by recurrence pattern.

    Tables

    Table 1
    Clinicopathological characteristics of patients

    Table 2
    Duration and site of recurrence

    Table 3
    Pattern of recurrence

    Table 4
    Results of multi-variant analysis of significant factors

    References

      1. Shin JK, Shin YD, Yoon C, Joo HZ. Risk factors affecting lymph node metastasis and recurrence in early gastric cancer. J Korean Gastric Cancer Assoc 2001;1:119–123.
      1. Ahn JS, Bang HY, Lee JI, Noh WC, Hwang DY, Choi DW, et al. Recurrence of early gastric cancer. J Korean Gastric Cancer Assoc 2001;1:180–186.
      1. Lai JF, Kim S, Kim K, Li C, Oh SJ, Hyung WJ, et al. Prediction of recurrence of early gastric cancer after curative resection. Ann Surg Oncol 2009;16:1896–1902.
      1. Lo SS, Wu CW, Chen JH, Li AF, Hsieh MC, Shen KH, et al. Surgical results of early gastric cancer and proposing a treatment strategy. Ann Surg Oncol 2007;14:340–347.
      1. Yuasa N, Nimura Y. Survival after surgical treatment of early gastric cancer, surgical techniques, and long-term survival. Langenbecks Arch Surg 2005;390:286–293.
      1. Lee HJ, Kim YH, Kim WH, Lee KU, Choe KJ, Kim JP, et al. Clinicopathological analysis for recurrence of early gastric cancer. Jpn J Clin Oncol 2003;33:209–214.
      1. Borie F, Millat B, Fingerhut A, Hay JM, Fagniez PL, De Saxce B. Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. Arch Surg 2000;135:1218–1223.
      1. Kim DY, Joo JK, Ryu SY, Kim YJ, Kim SK. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma. World J Gastroenterol 2004;10:737–740.
      1. Kikuchi S, Katada N, Sakuramoto S, Kobayashi N, Shimao H, Watanabe M, et al. Survival after surgical treatment of early gastric cancer: surgical techniques and long-term survival. Langenbecks Arch Surg 2004;389:69–74.
      1. Sano T, Sasako M, Kinoshita T, Maruyama K. Recurrence of early gastric cancer. Follow-up of 1475 patients and review of the Japanese literature. Cancer 1993;72:3174–3178.
      1. Saka M, Katai H, Fukagawa T, Nijjar R, Sano T. Recurrence in early gastric cancer with lymph node metastasis. Gastric Cancer 2008;11:214–218.
      1. Kim MK, An JY, Choi MG, Noh JH, Sohn TS, Kim S. Clinicopathologic characteristics of stage IV early gastric cancer. J Korean Gastric Cancer Assoc 2008;8:136–140.
      1. Furusawa M, Notsuka T, Tomoda H. Recurrence of early gastric cancer. Semin Surg Oncol 1991;7:344–350.
      1. Ichiyoshi Y, Toda T, Minamisono Y, Nagasaki S, Yakeishi Y, Sugimachi K. Recurrence in early gastric cancer. Surgery 1990;107:489–495.
      1. Yoshikawa T, Tsuburaya A, Kobayashi O, Sairenji M, Motohashi H, Noguchi Y. Is D2 lymph node dissection necessary for early gastric cancer? Ann Surg Oncol 2002;9:401–405.
      1. Shin DW, Hyung WJ, Noh SH, Min JS. Risk factors for recurrence after curative surgery for early gastric cancer. J Korean Gastric Cancer Assoc 2001;1:106–112.
      1. Kitamura K, Nishida S, Yamamoto K, Ichikawa D, Okamoto K, Yamaguchi T, et al. Poor prognosis in early gastric cancer complicated by five or more positive nodes. Hepatogastroenterology 1998;45:583–586.
      1. Japanese Gastric Cancer Association. Guidelines for Gastric Cancer Treatment. 2nd ed. Tokyo: Kanehara; 2004. pp. 9-11.
      1. Na KY, Chang YS, Kim YH, Joo SH, Lee SH. The prognostic significance of the preoperative serum CEA, CA19-9 and AFP levels in gastric cancer patients. J Korean Surg Soc 2008;75:302–306.
      1. Boku T, Nakane Y, Okusa T, Hirozane N, Imabayashi N, Hioki K, et al. Strategy for lymphadenectomy of gastric cancer. Surgery 1989;105:585–592.
      1. Kim DH, Song TJ, Kim SJ, Kim CS, Koo BH. Analysis of factors related to lymph node metastasis in early gastric cancers. J Korean Surg Soc 2000;58:375–382.
      1. Iriyama K, Asakawa T, Koike H, Nishiwaki H, Suzuki H. Is extensive lymphadenectomy necessary for surgical treatment of intramucosal carcinoma of the stomach? Arch Surg 1989;124:309–311.
      1. Baba H, Maehara Y, Okuyama T, Orita H, Anai H, Akazawa K, et al. Lymph node metastasis and marcoscopic features in early gastric cancer. Hepatogastroenterol 1994;41:380–383.
      1. Hioki K, Nakane Y, Yamamoto M. Surgical strategy for early gastric cancer. Br J Surg 1990;77:1330–1334.
      1. Habu H, Takeshita K, Sunagawa M, Endo M. Lymph node metastasis in early gastric cancer. Int Surg 1986;71:244–247.
      1. Sowa M, Kato Y, Nishimura M, Kubo T, Maekawa H, Umeyama K. Surgical approach to early gasrtic cancer with lymph node metastasis. World J Surg 1989;13:630–636.
      1. Hisamichi S, Sugawara N. Mass screening for gastric cancer by X-ray examination. Jpn J Clin Oncol 1984;14:211–223.
      1. Nagata T, Ikeda M, Nakayama F. Changing state of gastric cancer in Japan. Histologic perspective of the past 76 years. Am J Surg 1983;145:226–233.
      1. Folli S, Morgagni P, Roviello F, De Mazoni G, Marrelli D, Saragoni L, et al. Risk factors for lymph node metastasis and their prognostic significance in early gastric cancer (EGC) for the Italian Research Group for Gastric Cancer (IRGGC). Jpn J Clin Oncol 2001;31:495–499.
      1. Ha TK, Kwon SJ. Clinocopathologic characteristics according to the type of recurrence in curatively-resected gastric cancer patients. J Korean Gastric Cancer Assoc 2007;7:23–30.
      1. Kim YI, Noh SH, Lee WJ, Min JS. Recurrence pattern and prognosis after curative resection of gastric cancer. J Korean Surg Soc 1996;50:467–474.
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    MeSH Terms
    Follow-Up Studies
    Gastrectomy
    Humans
    Lymph Nodes
    Lymphatic Metastasis
    Prognosis
    Recurrence
    Retrospective Studies
    Risk Factors
    Seeds
    Stomach Neoplasms
    Survival Rate
    Metrics
    Share
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