Recurrence in patients following curative resection of early gastric carcinoma.

Objective: Post-gastrectomy recurrences of early gastric cancer occur in a few cases. We investigated the outcome of early gastric cancer patients treated surgically, with special respect to the risk factor(s) for tumor recurrence.

Patients And Methods: A total of 308 patients with mono-foci early gastric cancer underwent curative surgical resection. Clinicopathological variables and tumor recurrence patterns were analyzed retrospectively.

Results: Recurrence was observed in 30 out of 245 patients (12.24%) who had completed follow-up. The median interval from surgery to diagnosis of recurrence was 28 (range 3-188) months. Hematogenous recurrence (3.27%) was twice as frequent as peritoneal recurrence (1.63%). Gastric stump cancer occurred in 9 patients (3.67%), anastomotic recurrence in 7 patients (2.86%) and lymphatic recurrence in 4 patients (1.63%). Older patients (> or =60 years old) had a more frequent recurrence rate than younger patients (P < 0.05). Multivariate analyses identified lymph node metastasis and depth of invasion as risk factors of recurrence. All the patients with a positive family history of cancer got recurrence within 3 years after surgery.

Conclusions: Early gastric cancer patients, who were elderly, had lymphatic and submucosal involvement, and patients with a positive family history of cancer, tended to have a greater risk of recurrence.