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Factors affecting recurrence in node‐negative advanced gastric cancer
Author(s) -
Huang KuoHung,
Chen JenHao,
Wu ChewWun,
Lo SuShun,
Hsieh MaoChih,
Li Anna FY,
Lui WinYiu
Publication year - 2009
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2009.05844.x
Subject(s) - medicine , lymphovascular invasion , lymph node , adenocarcinoma , cancer , metastasis , oncology
Background and Aim: Prognostic factors of lymph node‐negative gastric adenocarcinoma after curative resection have been discussed. Recurrent pattern of advanced lymph node‐negative gastric cancer after curative resection has rarely been described. Methods: Recurrent sites and correlated clinicopathological factors of 372 patients with lymph node‐negative advanced gastric adenocarcinoma that underwent R0 resection from 1988 to 2005 were analyzed. Results: Recurrence was noted in 51 (13.7%) patients. Recurrent rates according to site of recurrence were 26 peritoneal seeding (51.0%), 26 locoregional (51.0%), 17 hematogenous (33.3%), and 4 lymph node metastasis (7.8%). Clinicopathological factors to predict peritoneal seeding were serosal exposure, lymphovascular invasion, Lauren's diffuse type differentiation and scirrhous stromal reaction. Serosal exposure, tumor size, microscopic infiltrating growth type predicts locoregional recurrence. Tumor had only lymphovascular invasion predict hematogenous spreading. Conclusion: Node‐negative advanced gastric cancer has more peritoneal seeding and locoregional recurrence. Aggressive cell behavior predicted the route of tumor cell spreading.