Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer

Background: Recurrence occurs in a variety of forms and in different organs after 'curative resection' of gastric cancer. This study investigated the postoperative prognosis for each type of recurrence. Methods: From 1969 to 1988, 939 patients with gastric cancer underwent cura tive resection; data on 130 of 207 patients who died with recurrence were a nalysed. Attention was focused on the site of recurrence and the postoperat ive outcome. Results: Haematogenous recurrence was evident in 54 per cent (70 of 130 pat ients), peritoneal recurrence in 43 per cent (56 of 130), lymph node recurr ence in 12 per cent (16 of 130) and local recurrence in 22 per cent (29 of 130). Thirty-three patients (25 per cent) had recurrences at multiple sites . Peritoneal and local recurrences were related to infiltrative growth, in contrast to haematogenous and lymphatic recurrences. There were no statisti cal differences in survival time among each type of recurrence and survival was not related to the number of sites of recurrence. Survival did not dep end on factors of sex, age, tumour location, tumour size, depth of invasion , tissue differentiation, histological growth pattern, lymphatic and vascul ar involvement, lymph node metastasis and extent of lymph node dissection. Conclusion: The clinicopathological characteristics of gastric cancer deter mine the type of recurrence, although the clinical outcome is the same for each type of tumour and is not related to the number of sites of recurrence .