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Prediction of early and late recurrence after curative resection for gastric carcinoma
1Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Background:
Although several prognostic factors for patients with gastric carcinoma have been demonstrated, those predictive of early and late recurrences after surgery are still unclear.
Methods:
Of 479 patients who underwent curative resection for gastric carcinoma from 1977 to 1987, 115 patients who died of recurrence were studied.
Results:
The patients were divided into 2 groups: an early recurrence group that included 80 patients who died within 3 years after surgery, and a late recurrence group, that included 35 patients who died more than 3 years after surgery. Early recurrence was characterized by a large tumor (8.1 cm vs. 6.7 cm; P<0.05) and many involved lymph nodes (7.7 vs 4.4; P<0.01). However, the depth of invasion, as well as the level of positive lymph nodes were not different between the two groups. Multivariate analysis showed that tumor size and the number of positive lymph nodes independently influenced the survival period.
Conclusions:
Tumor size and the number of positive lymph nodes are the most important factors predicting the timing of recurrence after curative resection for gastric carcinoma.