J Korean Surg Soc.  2009 Aug;77(2):96-105. 10.4174/jkss.2009.77.2.96.

Usefulness of Reoperation after Recurrence of Gastric Cancer

• Jeong GA
• Cho GS
• Lee MS
• Kim YJ
• Kang KH
• Kim HS
• Kim HC

• KMID: 2211288
• DOI: http://doi.org/10.4174/jkss.2009.77.2.96

Abstract

PURPOSE
Radical gastrectomy and lymph node dissection is the treatment of choice for gastric cancer but the efficacy of surgical treatment of recurrent gastric cancer has been debated. We evaluated the efficacy of surgical treatment for recurrent gastric cancer. METHODS: We collected the data on 108 recurrent gastric cancer patients who underwent radical gastrectomy and lymph node dissection for gastric cancer and analyzed the clinicopathologic data, the patterns of recurrence of gastric cancer, and the strategies of treatment for recurrent gastric cancer. RESULTS: The patterns of recurrence were 32 locoregional, 26 hematogenous, 24 peritoneal, and 26 mixed recurrences. The strategies of treatment for recurrent gastric cancer were the combination of surgical treatment and chemotherapy in 31 cases (28.7%), chemotherapy alone in 49 cases (45.4%), and conservative treatment in 28 cases (25.9%). The morbidity and mortality in reoperation group were 35.5% and 9.7%, respectively. The mean survival after recurrence was 25.4, 12.7, and 4.9 months in reoperation group, chemotherapy group and conservative treatment group, respectively. In multivariate analysis, the differentiation of primary tumor, patterns of recurrence, and the strategies of treatment for recurrent gastric cancer were related with survival after recurrence of gastric cancer. CONCLUSION: Our data suggested that the more aggressive and intensive treatment such as surgical treatment could improve the survival rate for recurrent gastric cancer. Therefore, if the patients' conditions are tolerable and there is resectability, surgical treatment may be an applicable strategy for recurrent gastric cancer in terms of long-term survival.

Keyword

Gastric cancer; Recurrence; Reoperation; Survival

MeSH Terms

Gastrectomy
Humans
Lymph Node Excision
Multivariate Analysis
Recurrence
Reoperation
Stomach Neoplasms
Survival Rate

Figure

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  Fig. 1 Patterns of recurrence and recurrent sites. 26 patients had two or more recurrence sites (mixed recurrence).

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  Fig. 2 Survival after recurrence of gastric cancer according to differentiation of primary cancer (A), patterns of recurrence (B), and the strategies of treatment for recurrent gastric cancer (C).

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