Patterns Of Recurrence And Analysis Of Factors Affecting Recurrence After Curative Resection For Adenocarcinoma Cancer

ObjectivesGastric cancer is one of the most common malignant tumors in China and one of the main causes of tumor death,and the incidence of gastric adenocarcinoma is the highest(95%).To explore the recurrence pattern of patients who were managed with curative res-ection and identify factors predictive of overall recurrence as well as specific patterns of recurrence,providing a scientific basis for postoperative adjuvant therapy of gastric cancer.MethodsOf the 130 patients included who undergoing curative resection for gastric cancer in Affiliated Hospital of Tai’shan Medical College between January 2013 and January 2016.84 patients met the inclusion and exclusion criteria,and received complete follow-up.Recurrences were classified as locoregional,peritoneal,or hematogenous(except perito-neal)metastasis.The relevant clinical data of patients were quantified,and the relevant data were corrected and then entered into the SPSS18.0statistical software;The statistical analysis was performed using the statistical analysis program package SPSS 18.0.Count date were applied in frequency and relative number,differences between groups were compared using chi square.Risk analysis were using Logistic regression analysis.A p-value of less than0.05 was considered statistically significant.Results1.In the patients with recurrence after curative resection for Gastric cancer,30 had a single recurrent pattern and 5 had more than one recurrent pattern.Patients that had a sin-gle recurrent pattern were 13 with peritoneal seeding,11 with locoregional and 6 with he-matogenous recurrence.2.Diameter of tumor larger than 5 cm,lymphovascular invasion,differentiation,T3/T4 stage,Lymph node metastasis,AJCC stage(P<0.05)were correlated with overall r-ecurrence after curative resection for Gastric cancer,The independent factors associated with overall recurrence included Diameter of tumor larger than 5 cm,AJCC stage(P< 0.05);3.Peritoneal recurrence after curative resection for Gastric cancer was associated with Diameter of tumor larger than 5 cm,differentiation,T3/T4 stage,Lymph node metastasis,AJCC stage(P<0.05);The independent factors associated with peritoneal recurrence inclu-ded Diameter of tumor larger than 5 cm,T3/T4 stage(P<0.05);4.Locoregional recurrence after curative resection for Gastric cancer was associated with Lymphovascular invasion,T3/T4 stage,AJCC stage(P<0.05);The independent facto-rs associated with Locoregional recurrence included AJCC stage(P<0.05);5.Hematogenous recurrence after curative resection for Gastric cancer was associated with Lymph node metastasis,AJCC stage(P<0.05).The independent factors associated wi-th hematogenous recurrence included AJCC stage(P<0.05).Conclusions1.The main recurrence patterns of patients with gastric cancer after radical resection were peritoneal recurrence and locoregional recurrence.2.Diameter of tumor larger than 5 cm,Lymphovascular invasion,moderately-poorly differentiated,T3/T4 stage,Lymph node metastasis,later stages were liable to happen rec-urrence after the radical resection;The independent factors about recurrence after curative resection for Gastric cancer were Diameter of tumor larger than 5 cm,TNM stage;3.Diameter of tumor larger than 5 cm,poorly differentiated,T3/T4 stage,Lymph node metastasis,later stages were liable to happen peritoneal recurrence after curative resection for Gastric cancer;The independent factors associated with peritoneal recurrence included Diameter of tumor larger than 5 cm,T stage;4.Lymphovascular invasion,T3/T4 stage,later stages were liable to happen Locoreg-ional recurrence after curative resection for Gastric cancer;The independent factors asso-ciated with Locoregional recurrence included AJCC stage.5.Lymph node metastasis,later stages were liable to happen hematogenous metastasis after curative resection for Gastric cancer;The independent factors associated with hemat-ogenous recurrence included AJCC stage.