Risk Factors For Peritoneal Recurrence In T3-4N0-1 Gastric Cancer Patients

PurposeTo assess the patterns,timing and risk factors for peritoneal recurrence in patients with T3-4N0-1 gastric cancer after curative gastrectomy.MethodsThe clinical and follow-up data of 344 patients with T3-4N0-1 gastric adenocarcinoma post curative resection,at Fujian Medical University Union Hospital between January 2010 and December 2015,were retrospectively analyzed.All patients underwent D2 radical gastrectomy and a Fluoropyrimidine based adjuvant chemotherapy.ResultsOne hundred and eighty-seven patients(54,36%)recurred after curative gastrectomy in the 344 enrolled patients.Among those 187 recurred patients,liver 81(43.31%)was the most common site of recurrence which was followed by peritoneum 32(17.11%),lymph nodes 29(15.51%)and anastomosis 21(11.23%).Depth of invasion,Tumor size,histological type and lymphovascular invasion were independently associated with recurrence.Peritoneal recurrence was associated with female gender,advanced T-stage and diffuse histological type.The median interval of peritoneal recurrence was 12 months which decreased with the increasing T-stage,and the median survival time was only 8 months.ConclusionsGastric adenocarcinoma patients with advance stage or with lymph node metastasis recurred frequently.Almost all recurrences occurred,within six months to two years post operatively,with the peritoneal cavity as the second major site,and was rapidly fatal.Therefore,developing therapeutic techniques towards peritoneal metastasis is extremely important to improve the prognosis of patients with T3-4N0-1 gastric cancer.