Analyses of Prognostic Factors and Gastric Cancer Specific Survival Rate in Early Gastric Cancer Patients and Its Clinical Implication

Hyung, Woo Jin; Cheong, Jae Ho; Kim, Junuk; Chen, Jian; Choi, Seung Ho; Noh, Sung Hoon

Abstract

PURPOSE
This study was performed to find out the risk factors for recurrence and prognosis of early gastric cancer (EGC) patients by evaluating the recurrence, overall survival, and disease-specific survival after curative resection. METHODS: Out of 4217 patients who had undergone gastric resections for gastric adenocarcinoma from 1987 to 1997, the records of 1264 curatively resected EGC patients were reviewed retrospectively. Risk factors that determined recurrence, overall survival, and stomach cancer specific survival were investigated by using uni-variate and multi -variate analyses. RESULTS: Among the 1264 patients, 62 patients (4.9%) were diagnosed as having recurrent cancer and 162 patients died during follow-up. Of these 162 patients, 53 (4.2% of 1264, 32.7% of 162) patients died of gastric cancer whereas 92 died of non-gastric cancer causes and 17 died of unknown causes. In uni-variate analyses, the depth of invasion and lymph node metastasis were risk factors for recurrence and gastric cancer-specific survival while age, histologic type, depth of invasion, and lymph node metastasis were risk factors for overall survival. In multi-variate analysis, lymph node metastasis was the only risk factor for recurrence and gastric cancer-specific survival, while age was the only risk factor for overall survival. In a detailed analysis of prognoses based on lymph node metastasis, recurrence and gastric cancer related death were more frequently noted in patients with 3 or more lymph node metastasis and with extra- perigastric lymph node metastasis. CONCLUSION: Although EGC patients treated by curative resection showed good prognosis, those with lymph node metastasis have risks of recurrence and gastric cancer- related death. Considering the high rate of recurrence and gastric cancer-related death, more attention should be given to EGC patients with 3 or more lymph node metastases and/or extra-perigastric lymph node metastases. Adjuvant chemotherapy might be recommended for these high-risk patients.