Recurrence following laparoscopy-assisted gastrectomy for gastric cancer: A multicenter retrospective analysis of 1,417 patients

Jyewon Song, Hyuk Joon Lee, Gyu Seok Cho, Sang Uk Han, Min Chan Kim, Seung Wan Ryu, Wook Kim, Kyo Young Song, Hyung Ho Kim, Woo Jin Hyung

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Abstract

Background. The risk of recurrence and recurrence patterns after laparoscopy-assisted gastrectomy for gastric cancer remain unclear. The objective of this study is to assess recurrence and its timing, patterns, and risk factors following laparoscopy-assisted gastrectomy from multicenter data. Methods. A retrospective multicenter study was performed using data from 1,485 patients who had undergone laparoscopy-assisted gastrectomy for gastric cancer at ten institutions from 1998 to 2005. Recurrence and its timing and patterns were reviewed. Univariate and multivariate analyses were performed to identify risk factors for recurrence. Results. Excluding 68 patients (9 postoperative mortalities, 1 synchronous distant metastasis, 2 nonadenocarcinomas, and 56 losses to follow-up), 50 of 1,417 patients (3.5%) had recurrences. Incidence of recurrence was 1.6% (19/1186) in early gastric cancer and 13.4% (31/231) in advanced gastric cancer. Recurrence occurred in 34 of 50 patients (68.0%) within 2 years of surgery, and in 45 of 50 patients (90.0%) within 3 years. The recurrence pattern was hematogenous in 17 patients (34.0%), peritoneal in 11 (22.0%), locoregional in 10 (20.0%), distant lymph nodes in 2 (4.0%), and mixed in 10 (20.0%). Advanced T-classification and lymph node metastases were risk factors for recurrence. Conclusions. Laparoscopy-assisted gastrectomy showed satisfactory long-term oncologic outcomes similar to those of open surgery. The study provides additional evidence suggesting that laparoscopy-assisted gastrectomy is a good alternative to open gastrectomy in patients with gastric cancer of relatively early stage, although results of a randomized controlled trial and more long-term follow-up are needed to provide conclusive evidence.

Original languageEnglish
Pages (from-to)1777-1786
Number of pages10
JournalAnnals of surgical oncology
Volume17
Issue number7
DOIs
Publication statusPublished - 2010 Jul 1

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Gastrectomy
Laparoscopy
Stomach Neoplasms
Recurrence
Lymph Nodes
Neoplasm Metastasis
Multicenter Studies
Multivariate Analysis
Randomized Controlled Trials
Retrospective Studies
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Song, Jyewon ; Lee, Hyuk Joon ; Cho, Gyu Seok ; Han, Sang Uk ; Kim, Min Chan ; Ryu, Seung Wan ; Kim, Wook ; Song, Kyo Young ; Kim, Hyung Ho ; Hyung, Woo Jin. / Recurrence following laparoscopy-assisted gastrectomy for gastric cancer : A multicenter retrospective analysis of 1,417 patients. In: Annals of surgical oncology. 2010 ; Vol. 17, No. 7. pp. 1777-1786.
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title = "Recurrence following laparoscopy-assisted gastrectomy for gastric cancer: A multicenter retrospective analysis of 1,417 patients",
abstract = "Background. The risk of recurrence and recurrence patterns after laparoscopy-assisted gastrectomy for gastric cancer remain unclear. The objective of this study is to assess recurrence and its timing, patterns, and risk factors following laparoscopy-assisted gastrectomy from multicenter data. Methods. A retrospective multicenter study was performed using data from 1,485 patients who had undergone laparoscopy-assisted gastrectomy for gastric cancer at ten institutions from 1998 to 2005. Recurrence and its timing and patterns were reviewed. Univariate and multivariate analyses were performed to identify risk factors for recurrence. Results. Excluding 68 patients (9 postoperative mortalities, 1 synchronous distant metastasis, 2 nonadenocarcinomas, and 56 losses to follow-up), 50 of 1,417 patients (3.5{\%}) had recurrences. Incidence of recurrence was 1.6{\%} (19/1186) in early gastric cancer and 13.4{\%} (31/231) in advanced gastric cancer. Recurrence occurred in 34 of 50 patients (68.0{\%}) within 2 years of surgery, and in 45 of 50 patients (90.0{\%}) within 3 years. The recurrence pattern was hematogenous in 17 patients (34.0{\%}), peritoneal in 11 (22.0{\%}), locoregional in 10 (20.0{\%}), distant lymph nodes in 2 (4.0{\%}), and mixed in 10 (20.0{\%}). Advanced T-classification and lymph node metastases were risk factors for recurrence. Conclusions. Laparoscopy-assisted gastrectomy showed satisfactory long-term oncologic outcomes similar to those of open surgery. The study provides additional evidence suggesting that laparoscopy-assisted gastrectomy is a good alternative to open gastrectomy in patients with gastric cancer of relatively early stage, although results of a randomized controlled trial and more long-term follow-up are needed to provide conclusive evidence.",
author = "Jyewon Song and Lee, {Hyuk Joon} and Cho, {Gyu Seok} and Han, {Sang Uk} and Kim, {Min Chan} and Ryu, {Seung Wan} and Wook Kim and Song, {Kyo Young} and Kim, {Hyung Ho} and Hyung, {Woo Jin}",
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Recurrence following laparoscopy-assisted gastrectomy for gastric cancer : A multicenter retrospective analysis of 1,417 patients. / Song, Jyewon; Lee, Hyuk Joon; Cho, Gyu Seok; Han, Sang Uk; Kim, Min Chan; Ryu, Seung Wan; Kim, Wook; Song, Kyo Young; Kim, Hyung Ho; Hyung, Woo Jin.

In: Annals of surgical oncology, Vol. 17, No. 7, 01.07.2010, p. 1777-1786.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Recurrence following laparoscopy-assisted gastrectomy for gastric cancer

T2 - A multicenter retrospective analysis of 1,417 patients

AU - Song, Jyewon

AU - Lee, Hyuk Joon

AU - Cho, Gyu Seok

AU - Han, Sang Uk

AU - Kim, Min Chan

AU - Ryu, Seung Wan

AU - Kim, Wook

AU - Song, Kyo Young

AU - Kim, Hyung Ho

AU - Hyung, Woo Jin

PY - 2010/7/1

Y1 - 2010/7/1

N2 - Background. The risk of recurrence and recurrence patterns after laparoscopy-assisted gastrectomy for gastric cancer remain unclear. The objective of this study is to assess recurrence and its timing, patterns, and risk factors following laparoscopy-assisted gastrectomy from multicenter data. Methods. A retrospective multicenter study was performed using data from 1,485 patients who had undergone laparoscopy-assisted gastrectomy for gastric cancer at ten institutions from 1998 to 2005. Recurrence and its timing and patterns were reviewed. Univariate and multivariate analyses were performed to identify risk factors for recurrence. Results. Excluding 68 patients (9 postoperative mortalities, 1 synchronous distant metastasis, 2 nonadenocarcinomas, and 56 losses to follow-up), 50 of 1,417 patients (3.5%) had recurrences. Incidence of recurrence was 1.6% (19/1186) in early gastric cancer and 13.4% (31/231) in advanced gastric cancer. Recurrence occurred in 34 of 50 patients (68.0%) within 2 years of surgery, and in 45 of 50 patients (90.0%) within 3 years. The recurrence pattern was hematogenous in 17 patients (34.0%), peritoneal in 11 (22.0%), locoregional in 10 (20.0%), distant lymph nodes in 2 (4.0%), and mixed in 10 (20.0%). Advanced T-classification and lymph node metastases were risk factors for recurrence. Conclusions. Laparoscopy-assisted gastrectomy showed satisfactory long-term oncologic outcomes similar to those of open surgery. The study provides additional evidence suggesting that laparoscopy-assisted gastrectomy is a good alternative to open gastrectomy in patients with gastric cancer of relatively early stage, although results of a randomized controlled trial and more long-term follow-up are needed to provide conclusive evidence.

AB - Background. The risk of recurrence and recurrence patterns after laparoscopy-assisted gastrectomy for gastric cancer remain unclear. The objective of this study is to assess recurrence and its timing, patterns, and risk factors following laparoscopy-assisted gastrectomy from multicenter data. Methods. A retrospective multicenter study was performed using data from 1,485 patients who had undergone laparoscopy-assisted gastrectomy for gastric cancer at ten institutions from 1998 to 2005. Recurrence and its timing and patterns were reviewed. Univariate and multivariate analyses were performed to identify risk factors for recurrence. Results. Excluding 68 patients (9 postoperative mortalities, 1 synchronous distant metastasis, 2 nonadenocarcinomas, and 56 losses to follow-up), 50 of 1,417 patients (3.5%) had recurrences. Incidence of recurrence was 1.6% (19/1186) in early gastric cancer and 13.4% (31/231) in advanced gastric cancer. Recurrence occurred in 34 of 50 patients (68.0%) within 2 years of surgery, and in 45 of 50 patients (90.0%) within 3 years. The recurrence pattern was hematogenous in 17 patients (34.0%), peritoneal in 11 (22.0%), locoregional in 10 (20.0%), distant lymph nodes in 2 (4.0%), and mixed in 10 (20.0%). Advanced T-classification and lymph node metastases were risk factors for recurrence. Conclusions. Laparoscopy-assisted gastrectomy showed satisfactory long-term oncologic outcomes similar to those of open surgery. The study provides additional evidence suggesting that laparoscopy-assisted gastrectomy is a good alternative to open gastrectomy in patients with gastric cancer of relatively early stage, although results of a randomized controlled trial and more long-term follow-up are needed to provide conclusive evidence.

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