Recurrent Patterns and Factors Involved in Node-negative Advanced Gastric Cancer

Objective: To investigate the recurrent patterns and factors involved in node-negative advanced gastric cancer after curative resection. Patients and Methods: Clinicopathological characteristics and prognostic outcomes of 310 patients who had lymph node-negative advanced gastric adenocarcinoma and received curative resection between 2002 and 2006 were retrospectively evaluated. Results: Among the 300 patients, 15 (5.0%) had locoregional recurrence, 5 (1.7%) had lymph node recurrence, 27 (9.0%) had peritoneal seeding recurrence, and 21 (7.0%) had hematogenous metastasis. Using multivariate analysis, we found that the maximum tumor diameter (P=0.014), histological type (P=0.001) and Borrmann type (P=0.033) were independent factors predicting the locoregional recurrence. Lymph node recurrence was significantly affected by lymph node dissection (P=0.029) and lymphovascular invasion (P=0.004). Clinicopathological factors predicting the peritoneal seeding recurrence were the depth of invasion (P=0.001) and Borrmann type (P=0.002). In addition, lymphovascular invasion (P=0.013) and histological type (P=0.001) were significantly associated with hematogenous metastasis. Conclusion: Node-negative advanced gastric cancer has a high amount of peritoneal seeding and hematogenous metastasis.