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Prediction of Recurrence of Early Gastric Cancer After Curative Resection

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Recurrence of early gastric cancer (EGC) after curative resection is rare, and the types of EGC that may recur have not been well studied. We attempted to create a system for predicting recurrence of EGC after R0 resection.

Methods

From January 1987 to April 2005, 2,923 patients with EGC who underwent curative resection were retrospectively studied. Of them, 79 patients (2.7%) experienced recurrence. Logistic regression was performed to identify independent risk factors for overall recurrence and early recurrence (recurred within 24 months after resection) of EGC. A nomogram was developed on the basis of a Cox regression.

Results

Median time to recurrence was 20.5 months, and early recurrence accounted for 60.7% of instances. Presence of lymph node metastasis and elevated gross type were independent risk factors for overall recurrence; patients with both identified risk factors had a higher recurrence rate than average level (17.5% vs. 2.7%, P < 0.001). Meanwhile, male gender, elevated gross type, and presence of lymph node metastasis were significantly associated with early recurrence, and in patients with all of the aforementioned identified risk factors, the early recurrence rate was higher (12.2% vs. 1.6%, P < 0.001). A nomogram for predicting the disease-free survival after operation was constructed. Its c-index was 0.79 and it appeared to be accurate.

Conclusions

Recurrence of EGC after curative resection can be predicted by using common clinical characteristics. Patients at high risk of overall and early recurrence could be identified; individual disease-free survival was predictable by the internally validated nomogram.

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Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong Seodaemun-gu, Seoul, Korea

    Ji Fu Lai MD, Sungsoo Kim MD, Chen Li MD, Sung Jin Oh MD, Woo Jin Hyung MD, Seung Ho Choi MD & Sung Hoon Noh MD

  2. Department of Surgery, Zhejiang Provincial People’s Hospital, Hangzhou, China

    Ji Fu Lai MD

  3. Cancer Metastasis Research Center, Yonsei University College of Dentistry, Seoul, Korea

    Sungsoo Kim MD, Sun Young Rha MD, Hyun Cheol Chung MD & Sung Hoon Noh MD

  4. Brain Korea 21 Project for Medical Science, Yonsei University College of Dentistry, Seoul, Korea

    Sun Young Rha MD, Hyun Cheol Chung MD & Sung Hoon Noh MD

  5. Department of Internal Medicine, Yonsei University College of Dentistry, Seoul, Korea

    Sun Young Rha MD & Hyun Cheol Chung MD

  6. Yonsei Gastric Cancer Clinic, Yonsei University College of Medicine, Yonsei University College of Dentistry, Seoul, Korea

    Sungsoo Kim MD, Sung Jin Oh MD, Woo Jin Hyung MD, Sun Young Rha MD, Hyun Cheol Chung MD, Seung Ho Choi MD & Sung Hoon Noh MD

  7. Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, Korea

    Kiyeol Kim PhD

  8. Department of Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Chen Li MD

  9. Department of Surgical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China

    Lin Bo Wang MD

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  1. Ji Fu Lai MD
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  2. Sungsoo Kim MD
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  3. Kiyeol Kim PhD
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  4. Chen Li MD
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  5. Sung Jin Oh MD
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  6. Woo Jin Hyung MD
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  7. Sun Young Rha MD
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  8. Hyun Cheol Chung MD
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  9. Seung Ho Choi MD
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  10. Lin Bo Wang MD
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  11. Sung Hoon Noh MD
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Corresponding author

Correspondence to Sung Hoon Noh MD.

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Lai, J.F., Kim, S., Kim, K. et al. Prediction of Recurrence of Early Gastric Cancer After Curative Resection. Ann Surg Oncol 16, 1896–1902 (2009). https://doi.org/10.1245/s10434-009-0473-x

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  • DOI: https://doi.org/10.1245/s10434-009-0473-x

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