Factors affecting recurrence in node-negative advanced gastric cancer

Area of Science:

• Oncology
• Gastroenterology
• Surgical Oncology

Background:

• Prognostic factors for lymph node-negative gastric adenocarcinoma post-curative resection are established.
• The recurrence patterns in advanced lymph node-negative gastric cancer after curative resection are less understood.

Purpose of the Study:

• To analyze the recurrence sites and associated clinicopathological factors in patients with lymph node-negative advanced gastric adenocarcinoma.

Main Methods:

• Retrospective analysis of 372 patients with lymph node-negative advanced gastric adenocarcinoma who underwent R0 resection.
• Data collected from 1988 to 2005.

Main Results:

• Recurrence occurred in 13.7% of patients (51/372).
• Major recurrence sites included peritoneal seeding (51.0%), locoregional recurrence (51.0%), and hematogenous spread (33.3%).
• Factors predicting peritoneal seeding: serosal exposure, lymphovascular invasion, Lauren's diffuse type, and scirrhous stromal reaction. Locoregional recurrence: serosal exposure, tumor size, infiltrating growth. Hematogenous spread: lymphovascular invasion.

Conclusions:

• Node-negative advanced gastric cancer exhibits a higher propensity for peritoneal seeding and locoregional recurrence.
• Aggressive tumor cell behavior is a key predictor of the metastatic pathway.