Factors associated with early recurrence after curative surgery for gastric cancer

Table 1 Initial recurrence patterns in the 194 patients with recurrence n (%)

Pattern	Total recurrence	Early recurrence	Late recurrence	P value
	n = 194 (100.0)	n = 129 (66.5)	n = 65 (33.5)
Hematogenous recurrence	77 (39.7)	56 (43.4)	21 (32.3)	0.136
Liver	55 (28.4)	42 (32.6)	13 (20.0)	0.067
Lung	16 (8.2)	10 (7.8)	6 (9.2)	0.724
Bone	14 (7.2)	8 (6.2)	6 (9.2)	0.442
Brain	3 (1.5)	2 (1.6)	1 (1.5)	0.995
Locoregional recurrence	99 (51.0)	68 (52.7)	31 (47.7)	0.509
Remnant stomach	10 (5.2)	6 (4.7)	4 (6.2)	0.734
Anastomosis	32 (16.5)	25 (19.4)	7 (10.8)	0.127
Perigastric area	40 (20.6)	27 (20.9)	13 (20.0)	0.880
Peripancreatic area	13 (6.7)	10 (7.8)	3 (4.6)	0.410
Abdominal wall	2 (1.6)	2 (1.9)	0 (0.0)	0.313
Local lymph node	34 (17.5)	27 (20.9)	7 (10.8)	0.079
Peritoneal recurrence	86 (44.3)	59 (45.7)	27 (41.5)	0.579
Distant lymphatic recurrence	11 (5.7)	7 (5.4)	4 (6.2)	1.000
Virchow’s node	6 (3.1)	4 (3.1)	2 (3.1)	1.000
Inguinal lymph node	1 (0.5)	0 (0.0)	1 (1.5)	0.335
Mediastinal lymph node	3 (1.5)	2 (1.6)	1 (1.5)	1.000
Para-aortic lymph node	2 (1.0)	2 (1.6)	0 (0.0)	0.552

P values were evaluated by Pearson’s χ² test or Fisher’s exact test, as appropriate. Some patients experienced initial recurrence at multiple sites.

Table 2 Univariate analysis of factors predicting early recurrence in patients with early gastric cancer n (%)

Variable	Early recurrence	Late/no recurrence	Univariate analysis
	n = 4	n = 76	P value
Gender			0.623
Women	1 (25.0)	35 (46.1)
Men	3 (75.0)	41 (53.9)
Age at diagnosis (yr)			0.646
≤ 60	3 (75.0)	45 (59.2)
60	1 (25.0)	31 (40.8)
Tumor size (cm)			0.011
≤ 5.0	2 (50.0)	74 (97.4)
>5.0	2 (50.0)	2 (2.6)
Lauren histotype			0.646
Intestinal	3 (75.0)	45 (59.2)
Diffuse-mixed	1 (25.0)	31 (40.8)
Lymphovascular invasion			< 0.144
Present	1 (25.0)	2 (2.6)
Absent	3 (75.0)	74 (97.4)
pT stage			< 0.639
pT1a	2 (50.0)	47 (61.8)
pT1b	2 (50.0)	29 (38.2)
pN stage			0.048
N0	2 (50.0)	70 (92.1)
N1, N2	2 (50.0)	6 (7.9)
Intraoperative chemotherapy			1.000
Yes	1 (25.0)	19 (25.0)
No	3 (75.0)	57 (75.0)

P values were evaluated by Fisher’s exact test.

Table 3 Univariate analysis of factors predicting early recurrence in patients with locally advanced gastric cancer n (%)

Variable	Early recurrence	Late/no recurrence	Univariate analysis
	n = 125	n = 212	P value
Gender			0.683
Women	41 (32.8)	65 (30.7)
Men	84 (67.2)	147 (69.3)
Age at diagnosis (yr)			0.016
≤ 60	52 (41.6)	117 (55.2)
> 60	73 (58.4)	95 (44.8)
Tumor size (cm)			0.019
≤ 5.0	76 (60.8)	155 (73.1)
> 5.0	49 (392)	57 (26.9)
Lauren histotype			0.016
Intestinal	85 (68.0)	169 (79.7)
Diffuse-mixed	40 (32.0)	43 (20.3)
Lymphovascular invasion			< 0.001
Present	21 (16.8)	9 (4.2)
Absent	104 (83.2)	203 (95.8)
pT stage			< 0.001
pT2, pT3	30 (24.0)	105 (49.5)
pT4a	95 (76.0)	107 (50.5)
pN stage			< 0.001
N0	13 (10.4)	82 (38.7)
N1	25 (20.0)	52 (24.5)
N2	30 (24.0)	46 (21.7)
N3	57 (45.6)	32 (15.1)
Intraoperative chemotherapy			< 0.001
Yes	54 (43.2)	136 (64.2)
No	71 (56.8)	76 (35.8)
Postoperative chemotherapy			0.036
No	42 (33.6)	49 (23.1)
5-FU-based regimen	83 (66.4)	163 (76.9)

P values were evaluated by Pearson’s χ² test.

Table 4 Multivariate analysis of factors predicting early recurrence by binary logistic regression model

Factor	P value	OR	95%CI
A Age at diagnosis	0.033	1.813	1.050-3.131
pT pT stage	< 0.001	2.865	1.603-5.123
pN stage	< 0.001
N0		1.00 (reference)
N1	0.001	4.029	1.708-9.500
N2	0.001	4.425	1.889-10.365
N3	< 0.001	9.860	4.314-22.536
Lauren histotype	< 0.001	3.492	1.810-6.736
Lymphovascular invasion	0.011	3.460	1.335-8.969
Intraoperative chemotherapy	< 0.001	0.327	0.190-0.564
Postoperative chemotherapy	0.007	0.423	0.225-0.793

The constant of the model was -2.087 (standard error = 0.468).