Clinicopathologic study of node-negative advanced gastric cancer and analysis of factors predicting its recurrence and prognosis

Am J Surg. 2013 Jun;205(6):623-30. doi: 10.1016/j.amjsurg.2012.04.014. Epub 2012 Oct 1.

Abstract

Background: This study aimed to reveal the predictors for the recurrence pattern of gastric cancer (GC) and analyze the prognostic factors in node-negative advanced (T2 to T4) GC after curative resection.

Methods: Between 1994 and 2006, 448 patients with node-negative advanced GC undergoing radical resection were enrolled in this study. Clinicopathologic factors affecting the recurrence pattern and prognosis for GC were analyzed.

Results: Location, size, tumor invasion depth, and perineural invasion were associated with tumor recurrence and outcome. T4 status was a predictor for locoregional recurrence and peritoneal seeding, and a large tumor size and the presence of perineural invasion predicted hematogenous spread. Patients with only locoregional recurrence had better survival than those with peritoneal seeding or hematogenous spread.

Conclusions: In node-negative advanced GC, the prognostic factor differed significantly between locoregional recurrence/peritoneal seeding and hematogenous metastasis. Survival rates were higher in patients with locoregional recurrence alone than in patients with other recurrence patterns.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Disease-Free Survival
  • Female
  • Gastrectomy
  • Humans
  • Lymph Node Excision*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Seeding
  • Prognosis
  • Risk Factors
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery*