Title The patterns and timing of recurrence after curative resection for gastric cancer in China
Authors Liu, Dan
Lu, Ming
Li, Jian
Yang, Zuyao
Feng, Qi
Zhou, Menglong
Zhang, Zhen
Shen, Lin
Affiliation Peking Univ, Canc Hosp & Inst, Dept Gastrointestinal Oncol, Key Lab Carcinogenesis & Translat Res,Minist Educ, 52 Fucheng Rd, Beijing 100142, Peoples R China.
Chinese Univ Hong Kong, Jockey Club Sch Publ Hlth & Primary Care, Div Epidemiol, Hong Kong 999077, Hong Kong, Peoples R China.
Fudan Univ, Shanghai Canc Ctr, Dept Radiat Oncol, Shanghai 200032, Peoples R China.
Peking Univ, Canc Hosp & Inst, Dept Gastrointestinal Oncol, Key Lab Carcinogenesis & Translat Res,Minist Educ, 52 Fucheng Rd, Beijing 100142, Peoples R China.
Zhang, Z (reprint author), Fudan Univ, Shanghai Canc Ctr, Dept Radiat Oncol, Shanghai 200032, Peoples R China.
Keywords Gastric cancer
Curative resection
Postoperative recurrence
Disease free survival
Overall survival
PHASE-III TRIAL
RISK-FACTORS
PLUS CISPLATIN
SURGERY
ADENOCARCINOMA
GASTRECTOMY
SURVIVAL
CHEMOTHERAPY
CARCINOMA
OUTCOMES
Issue Date 2016
Publisher WORLD JOURNAL OF SURGICAL ONCOLOGY
Citation WORLD JOURNAL OF SURGICAL ONCOLOGY.2016,14.
Abstract Background: The recurrence of gastric cancer after curative resection had adverse effects on patients' survival. The treatment presence varied from different countries. The aims of this study were to understand the recurrence incidence, patterns, and timing and to explore the risk factors in China. Methods: One thousand three hundred four patients who undergoing curative resection from more than 100 hospitals between January 1st 1986 and September 1st 2013, were surveyed in detail. Clinical pathological factors were examined as potential risk factors of each recurrence pattern using univariate and multivariate analyses. Recurrence timing was also analyzed based on disease-free survival. Results: Among 1304 gastric cancer patients, 793 patients (60.8%) experienced recurrence and 554 patients (42.5%) experienced recurrence within 2 years after operation. The median disease-free survival was 29.00 months (interquartile range [IQR] 12.07, 147.23). Receiving operation in general hospitals was one of independent risk factors of local-regional recurrence (OR = 1.724, 95% CI 1.312 to 2.265) and distant metastasis (OR = 1.496, 95% CI 1. 164 to 1.940). Patients would suffer lower risk of distant metastasis if they received no more than 3 cycles adjuvant chemotherapy (OR = 0.640, 95% CI 0.433 to 0.943). Adjuvant radiotherapy could reduce the risk of recurrence (OR 0. 259, 95% CI 0.100 to 0.670), especially distant metastasis (OR = 0.260, 95% CI 0.083 to 0.816). Conclusions: More than 60% patients experienced recurrence after curative resection for gastric cancer, especially within 2 years after surgery. Risk factors were clarified between various recurrence patterns. Advanced gastric cancer and undergoing operation in general hospitals contributed to increased recurrence risk and worse survival. Enough number of lymph nodes harvest and standard D2 lymphadenectomy could reduce recurrence. Chinese patients would benefit from adjuvant chemotherapy and radiotherapy.
URI http://hdl.handle.net/20.500.11897/458089
ISSN 1477-7819
DOI 10.1186/s12957-016-1042-y
Indexed SCI(E)
Appears in Collections: 北京肿瘤医院

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