PURPOSE: The incidence of early gastric cancer (EGC) is increasing in Korea. The prognosis of EGC is excellent but a small portion of patients experience recurrence after curative resection. We aimed to study recurrence rate of EGC, recurrence pattern of EGC and to find predicting factors for recurrence. We analyzed treatment results after recurrence in EGC.
MATERIALS AND METHODS: One thousand four hundred fifty eight patients with EGC at Department of Surgery, Seoul National University Hospital (1986~1995) were reviewed for recurrence retrospectively.
RESULTS: Twenty-six patients had recurrence after curative resection (1.79%). Thirteen cases (50%) recurred within 24 months (early recurrence) and late recurrence after 60 months occured in 4 cases (15%). The common modes of recurrence were locoregional (9, 34.6%) and distant metastasis (9, 34.6%). Submucosal invasion was in 19 cases and lymph node metastasis was positive in 14 cases. Median survival after recurrence was 5.6 months.
Median survival after recurrence was 3.1 months after conservative management, 5.8 months after chemotherapy, and 46.8 months after resection.
Recurrence rate was significantly higher in submucosal invasion group than mucosal invasion group (2.6% vs. 1.0%, p<0.05) and lymph node metastasis positive group than negative group (7.4% vs. 1.0%, p <0.001) by univariate analysis. Multivariate analysis revealed significantly high correlation between positive lymph node metastasis and recurrence (p < 0.001).
CONCLUSION: Lymph node metastasis is the most significant predictor of recurrence.
Resection for locoregional recurrence can be beneficial.
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