Pathological features as predictors of recurrence after radical resection of gastric cancer

Background: The aim of this study was to investigate the pattern and timing of recurrence and to determine associated risk factors after radical resection of gastric cancer including D2 dissection. Methods: A total of 274 patients who had undergone radical resection of gastric cancer with nodal involvement or T3–4 tumour were randomized to receive chemotherapy or no further treatment (control group). Locoregional recurrence and distant metastasis were analysed in a competing risks framework, by estimating the crude cumulative incidence in each group. Multiple regression models were used to investigate the influence of treatment and pathological features on the risk of recurrence. Results: Overall, the 7 year rate of locoregional relapse was 15·8 per cent and that of distant recurrence was 34·5 per cent. There was a significant association between pathological node (pN) stage and distant relapse (P < 0·001), and between pathological tumour (pT) stage and locoregional recurrence (P = 0·024). Chemotherapy had no significant effect on either locoregional or distant recurrence. Conclusion: The rate of locoregional recurrence after radical surgery for gastric cancer was lower than that in studies based on more conservative surgery. The pT stage was related to the rate of locoregional recurrence whereas pN stage had an impact on distant recurrence. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.