The Pattern of Recurrence after Curative Resection of Gastric Cancer in a Tertiary Cancer Center in North India

To study the recurrence pattern according to the location of the tumor, predictors, and survival as per the type of recurrence in gastric cancer. Retrospective analysis of gastric cancer patients who underwent curative resection was done on a prospectively maintained computerized database from 2000 to 2021 in Dr. BRAIRCH, AIIMS, New Delhi. After a median follow-up of 50 months, 101 recurrences (50.75%) were detected among 199 curative resections. Recurrences were categorized into nonperitoneal distant (40.6%), peritoneal (28.7%), locoregional (22.8%), and mixed type (7.9%). For all the subsites most common type of recurrence was distant recurrence (Distal stomach- 38%, proximal stomach-55%, and body-41%). Most common site of recurrence was liver (32.7%), followed by peritoneum (28.7%), locoregional node (15.8%), mixed type (7.9%), anastomotic site (6.9%), lung (5.9%), and bone (2.0%). No statistically significant difference was noted among different subsites (p = 0.566), and specific site (p = 0.649). Weight loss, lymphovascular invasion, pathological stage, and pathological T stage, and node ratio are significant predictors of recurrence. Median disease-free survival was 29 months (95% CI-24.455-33.545). Median overall survival for peritoneal recurrence was 34 months (95%CI-31.48-36.52), distant site 38 months (95%CI-26.789-49.211), locoregional 51 months (95%CI-41.609-60.319), and mixed type 56 months (95%CI-47.684-64.316). Despite the improvement of multimodal management, recurrence is the main hindrance to survival. Distant and peritoneal recurrence are the major concern after curative resection of gastric cancer, with a less survival time compared to the locoregional and mixed type of recurrence.