Risk factors for recurrence of gastric cancer after curative laparoscopic gastrectomy

J Med Invest. 2017;64(1.2):79-84. doi: 10.2152/jmi.64.79.

Abstract

Introduction: Curative laparoscopic gastrectomy (LG) is associated with good outcomes when performed for early gastric cancers. The aim of this study was to identify risk factors for recurrence after LG.

Methods: 212 patients with gastric cancer who underwent gastrectomy were enrolled (LG: 143, open gastrectomy, OG: 69). Univariate analysis was used to assess overall (OS) and disease-free survival (DFS) in LG and OG group. Multivariate analysis was used to assess risk factors for recurrence after LG.

Results: In LG, six cases of recurrence were observed (liver: 2, peritoneum: 4). Neither lymph node nor port-site recurrences were evident after LG. The 5-year DFS after LG was 91.4%. Based on univariate analysis of 5-year DFS, three negative prognostic factors-lymph node metastasis, lymphatic invasion, and venous invasion-were identified. The independent risk factor for recurrence of LG was lymph node metastasis. LG and OG showed no significant differences in 5-year DFS among Stage IA, IB, IIA, and IIB groups. Independent risk factors for recurrence after LG or OG were tumor invasionā‰„muscularis mucosa and lymph node metastasis.

Conclusions: DFS following LG is comparable to that following OG. Lymph node metastasis is an independent risk factor for gastric cancer recurrence after LG. J. Med. Invest. 64: 79-84, February, 2017.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Gastrectomy / methods
  • Humans
  • Laparoscopy
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / etiology*
  • Neoplasm Staging
  • Risk Factors
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*