Outcome of surgical treatment for patients with locoregional recurrence of gastric cancer.

PURPOSE

Locoregional recurrent gastric cancer is commonly treated by systemic chemotherapy. The effectiveness of surgical treatment, in terms of complete tumor resection, is unknown.

METHODS

We reviewed the case histories of 36 patients with locoregional recurrent gastric cancer, selected for surgical treatment by careful preoperative assessment. Patient characteristics and survival data were collected and analyzed. Prognostic factors were also assessed by univariate analysis using the log-rank test.

RESULTS

Among 36 patients with recurrent gastric tumors, including 18 patients with local recurrences and 18 patients with single-regional lymph node recurrences, the average time to recurrence after initial surgery was 26.4 ± 2.8 months. Complete resection was possible in 29 patients (80.6%), with incomplete resection in the remaining seven patients (19.4%). Various types of surgery were used for tumor recurrence; 23 patients (63.9%) underwent procedures to resect the tumor and the affected organs. The median survival time (median ± standard error) was 23.0 ± 2.8 months, and overall 1-, 3-, and 5-year survival rates were 73.0%, 36.7%, and 9.8%, respectively. Complete resectability of the tumor was the only significant prognostic factor identified.

CONCLUSIONS

Although there was no control group in the present study with similarly limited tumor recurrence and treated solely with modern systemic chemotherapy, such a study population would be too small to conduct a randomized study in. For those patients for whom surgery is indicated by multidisciplinary assessment, surgical resection can be applied for recurrent lesions if complete resection can be accomplished with low perioperative risk for the extended surgery.