Abstract
Local recurrence is common after radical surgery. However, the factors that contribute to survival after local recurrence remain unclear. In this retrospective study we analyzed the relationship between time to recurrence and survival after recurrence in 74 patients with locally recurrent gastric cancer. All patients received palliative radiotherapy with or without chemotherapy. The patients were divided into two groups according to the time between gastrectomy and local recurrence: early local recurrence (ELR, < 12 months after primary surgery), and late local recurrence (LLR, ≥12 months after primary surgery). The median overall survival (OS) time was 15 months for patients with ELR and 25 months for LLR patients. Univariate and multivariate analysis revealed that time to local recurrence was significantly associated with OS after local recurrence (P = 0.001). The hazard ratio of ELR compared with LLR patients was 0.442 (95% confidence interval: 0.264-0.741). These results indicate that early local recurrence predicted poor prognosis in gastric cancer patients with unresectable local recurrence.
Highlights
Gastric cancer is the second leading cause of cancer-related mortality, and remains the fourth most common cancer worldwide [1]
We found the mortality of gastric cancer patients with early local recurrence and no chance for further surgery to be higher mortality after diagnosis of local recurrence
Risk of death was almost two-fold higher in patients with early local recurrence than those with late local recurrence
Summary
Gastric cancer is the second leading cause of cancer-related mortality, and remains the fourth most common cancer worldwide [1]. In China, the morbidity and mortality of gastric cancer are higher than all but one other type of cancers [2]. Several studies of clinical follow-up, reoperation and autopsies have reported that 40%-60% of patients with completely resected gstage II or III gastric cancer developed a locoregional recurrence before adjuvant therapy was applied [3]. Local-regional failure most often occurs in anastomosis, followed by the stomach bed and undissected regional nodes [4]. Due to dysphagia, bleeding and pain, some patients with locoregional recurrence cannot be treated surgically and receive only palliative therapy [5]. The median overall survival (OS) of these patients was only 5 months (range 0.2-82 months) [6]
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