Analysis Of Recurrence After Radical Gastrectomy For Distal Gastric Cancer

Objective: To investigate the recurrence of gastric cancer after radical gastrectomy and to explore a new point of thinking in the treatment of gastric cancer.Methods: A total of 372 patients with radical gastrectomy who underwent radical gastrectomy from July 2010 to October 2015 were enrolled in this study.According to the inclusion and exclusion criteria,65 patients with recurrent patients were retrospectively reviewed.Analysis of patients with clinical and pathological and other related information.Including the basic information of the patients and the factors that may affect the recurrence and metastasis of the site and recurrence time,such as gender,age,primary tumor site,preoperative CEA,surgical approach,digestive tract reconstruction,primary tumor size,histological type,Differentiation degree,depth of invasion,lymph node metastasis,tumor duration,analysis of the location of recurrence and metastasis of patients,the recurrence of the basic situation and its relationship with avariety of related factors.The measurement data were expressed as mean ±standard deviation(X ± S).Analysis of factors related to recurrence and metastasis of patients with distal gastrectomy and radical resection were compared with Chi-square test(test).P<0.05 indicates that the difference was statistically significant.Results: Of the 372 patients,65 cases had recurrence rate.The total recurrence rate was 17.5%.There were 42 cases of distant metastasis,the distant transfer rate was 11.3%,64.6% of recurrent patients and 23 cases of local recurrence,the local recurrence rate of 6.2%,accounting for 35.4% of patients with recurrent.Most patients in 2 years of recurrence and metastasis,a total of49 cases,more than two years of long-term recurrence of patients with 16 cases.The median time to relapse was 13 months(range,3-73 months).The median time to distant metastasis was 11.5 months(range,3-73 months).The median time to local recurrence was 14 Month(range 3-46 months).(P = 0.006)and tumor disease(P = 0.006)were significantly correlated with postoperative recurrence and metastasis.There was a significant correlation between tumor stage(P = 0.011)and postoperative recurrence time,The difference is statistically significant,the later the tumor disease,the greater the likelihood of distant metastasis and early recurrence.There was no significant correlation between the operation mode,the way of digestive tract reconstruction,the distance of resection and the recurrence and metastasis of the patients.Conclusions: 1.The recurrence and metastasis of patients with radical gastrectomy after radical gastrectomy were mainly distant metastasis.2.patients with gastric cancer after radical resection in the early recurrence is more common,recurrence time and tumor disease has a significant correlation,early follow-up should be followed closely.3.Gastric cancer surgery should pay more attention to the problem of distant metastasis after surgery,in some cases,too much emphasis on the distance of the proximal margin should be further explored.