Prognosis of patients with recurrence after curative resection of advanced gastric cancer

OBJECTIVE: To investigate the clinical features and prognosis of recurrent gastric cancer. METHODS: Clinical data of 163 patients with recurrent gastric cancer from Jan. 2001 to Jan. 2005 were reviewed. Patients were compared between those with and without symptoms. RESULTS: Seventy-two patients(44.2%) were symptomatic, while 91(55.8%) were asymptomatic. There were significant differences in lymph node metastasis between the two groups(P<0.05). The median overall survival was significantly longer in asymptomatic patients (19.8 vs. 15.7 months, P<0.05). Post-recurrence survival was also longer in the asymptomatic group (9.5 vs. 4.8 months, P<0.01). The median recurrence-free interval in asymptomatic patients was 10.0 months, which was significantly longer than that in the symptomatic patients (9.2 months, P<0.05). On univariate survival analysis,post-gastrectomy chemotherapy (P<0.05), symptoms of recurrence(P<0.01), TNM staging(P<0.01), recurrence-free interval (P<0.01), and reoperation(P<0.01) were associated with the prognosis. On multivariable analysis, TNM staging(P<0.01), symptoms of recurrence(P<0.01), recurrence-free interval (P<0.05), and reoperation(P<0.05) were independent risk factors. CONCLUSIONS: Patients with recurrent gastric cancer have poor prognosis. Close monitoring and active follow-up of patients with gastric cancer should be conducted during the first two years after operation. Reoperation may improve survival in patients with recurrent gastric cancer.