Prediction of early recurrence after radical resection for advanced gastric cance

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/Zhao Jingzhu

(趙敬柱，Dept Gastric Cancer Inst，Hosp Tianjin Med Univ，Tianjin 300060)…∥Chin JGen Surg.-2011，14(8).-549～552

ObjectiveTo investigate the clinical features and prognosis of recurrent gastric cancer.MethodsThe clinical data of 147 patients with recurrent gastric cancer was reviewed.Risk factors correlated with tumor recurrence and recurrent intervals were studied by logistic regression analysis.Survival analyses and comparisons were performed using Kaplan-Meier plots，the log rank test and the Cox proportional hazards model.ResultsPatients were divided into an"early recurrence group"consisting of 86 patients(recurred within one year after surgery)and a"late recurrence group"of 61 patients(recurred one year or more after surgery).There were significant difference in size of primary tumor，Borrmann stage，type of gastrectomy，T stage，N stage，TNM stage between the two groups(P ＜0.05).Multivariate analysis showed that the TNM stage and N stage independently influenced the recurrent time(P ＜ 0.05).In univariate survival analysis，post-gastrectomy chemotherapy(P ＜ 0.05)，T stage(P ＜ 0.05)，N stage(P ＜ 0.01)，TNM stage(P ＜0.01)，recurrence-free interval(P ＜ 0.01)and reoperation(P ＜0.01)were significantly correlated with the prognosis.In multivariable analysis，TNM stage(P ＜0.01)，recurrence-free interval(P ＜ 0.05)and reoperation(P ＜0.05)were independent factors predicting recurrence.ConclusionThe TNM stage and N stage are the important factors predicting the time of recurrence after curative resection for gastric cancer.Patients with recurrent gastric cancer have poor prognosis and reoperation is associated with an improved survival in patients with recurrent gastric cancer.11 refs，1 fig，4 tabs.