Original scientific articleRisk factors for liver metastases after curative surgical procedures for gastric cancer: a prospective study of 208 patients treated with surgical resection☆
Section snippets
Patients
For this study we considered 381 patients who had undergone resective surgical treatment for primary gastric cancer at our Institute between January 1988 and December 1997. From this series only patients who met the following criteria were selected: 1) those who underwent potentially curative surgical treatment, defined according to the Union Internationale Contra le Cancer (UICC) criteria;7 2) those who showed absence of second tumors; 3) those who gave their informed consent for the followup
Sites of recurrence
Recurrence of gastric cancer arose during the followup in 109 of 208 cases (52.4%). The 5-year disease-free survival of the entire patient population was 48.6% (Fig. 1). In 69 cases (33.2%) we observed locoregional recurrences; in 31 cases (14.9%) peritoneal carcinomatosis; and in 36 cases (17.3%) hematogenous dissemination. Multiple sites of recurrence were found in 22 of 109 recurrent cases.
Hepatic recurrence
Of the 36 patients with hematogenous metastases the liver was involved in 28 patients, with an
Discussion
Recurrence of gastric cancer is a frequent finding even after a potentially curative surgical procedure and takes place through three main ways of spreading: locoregional recurrence, peritoneal dissemination, and hematogenous metastases. Several autopsy and clinical studies are reported in the literature. Some of these studies showed that different clinical and pathologic variables are related to the various patterns of dissemination2, 3, 5, 6, 11, 12; but most of the clinical studies were
Acknowledgements
We thank Marie Basso for assistance with revision of the manuscript.
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No competing interests declared.
Supported by grant PAR 2000 from the University of Siena, Italy.