Risk factors for recurrence of gastric cancer after curative laparoscopic gastrectomy.

INTRODUCTION

Curative laparoscopic gastrectomy (LG) is associated with good outcomes when performed for early gastric cancers. The aim of this study was to identify risk factors for recurrence after LG.

METHODS

212 patients with gastric cancer who underwent gastrectomy were enrolled (LG: 143, open gastrectomy, OG: 69). Univariate analysis was used to assess overall (OS) and disease-free survival (DFS) in LG and OG group. Multivariate analysis was used to assess risk factors for recurrence after LG.

RESULTS

In LG, six cases of recurrence were observed (liver: 2, peritoneum: 4). Neither lymph node nor port-site recurrences were evident after LG. The 5-year DFS after LG was 91.4%. Based on univariate analysis of 5-year DFS, three negative prognostic factors-lymph node metastasis, lymphatic invasion, and venous invasion-were identified. The independent risk factor for recurrence of LG was lymph node metastasis. LG and OG showed no significant differences in 5-year DFS among Stage IA, IB, IIA, and IIB groups. Independent risk factors for recurrence after LG or OG were tumor invasion≥muscularis mucosa and lymph node metastasis.

CONCLUSIONS

DFS following LG is comparable to that following OG. Lymph node metastasis is an independent risk factor for gastric cancer recurrence after LG. J. Med. Invest. 64: 79-84, February, 2017.