Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE: Recurrent gastric cancer has a very poor prognosis due to its diagnostic difficulties, variant recurrence patterns and no effective treatment modalities. In this study, we retrospectively analyzed treatment results of the recurrent gastric cancer.
MATERIALS AND METHODS: We reviewed 1,286 patients who had taken radical surgery for primary gastric cancers and were diagnosed to have recurrences of their primary diseases. According to the medical records, we retrospectively analyzed the gross features, histologic types and TNM stages of primary gastric cancers. The symptoms, diagnostic modalities, durations, recurrence patterns, treatments and prognoses of recurrent diseases were also reviewed.
RESULTS: The median survival time of total recurrent gastric cancer patients was 6.8 months.
Ldegrees Co-regional and distant recurrences had better results than peritoneal and mixed recurrences (p<0.01). Curative resection of recurrent cancer was done in only 1.6% (18 cases in ldegrees Co-regional recurrence and 4 cases in distant recurrence), but in these cases, significant survival gain (5 year survival rate: 30.5%) was found compared to other treatment modalities (p<0.01). In multivariate analysis, the type of first operation, TNM stage, duration till recurrence, recurrence pattern, and treatment modality of recurrence were meaningful for the survival time after recurrence.
CONCLUSION: In selective cases, recurrent gastric cancer had an effective treatment modality and was expected to have prolonged survival. Therefore, a careful diagnosis and an active treatment of the patients who have the recurrent gastric cancers should be done, especially for the ldegrees Co-regional recurrence.
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