Recurrence of early gastric cancer

We investigated the postoperative deaths and recurrence among 673 patients with early gastric cancer who had undergone gastric resection at the National Kyushu Cancer Center Hospital from March 1972 to December 1988. The mode and time of recurrence were assessed with reference to the clinicopathological findings at initial surgery. Fifteen patients (2.2%) died of cancer recurrence, and 18 patients (2.7%) developed recurrence (3 patients are currently alive after reoperation). A comparison of modes of recurrence revealed that the incidence of hematogenous recurrence was the highest with nine cases, followed by recurrence in the remnant stomach in three cases and by local, lymph node, and peritoneal recurrences in two cases each. Twelve patients developed recurrence within 5 years after operation (early recurrence) and six patients after 5 years (late recurrence). Cases positive for cancer cell invasion into intralesional veins at initial surgery had a significantly higher recurrence rate than negative cases (P less than 0.001). Thus, venous invasion was the most important factor for the development of recurrence in the patients with early gastric cancer.