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Prediction of recurrence of early gastric cancer after curative resection

 Ji Fu Lai  ;  Sungsoo Kim  ;  Kiyeol Kim  ;  Chen Li  ;  Sung Jin Oh  ;  Woo Jin Hyung  ;  Sun Young Rha  ;  Hyun Cheol Chung  ;  Seung Ho Choi  ;  Lin Bo Wang  ;  Sung Hoon Noh 
 ANNALS OF SURGICAL ONCOLOGY, Vol.16(7) : 1896-1902, 2009 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy ; Humans ; Lymph Nodes/pathology* ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Nomograms ; Predictive Value of Tests ; Prognosis ; Regression Analysis ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Young Adult
BACKGROUND: Recurrence of early gastric cancer (EGC) after curative resection is rare, and the types of EGC that may recur have not been well studied. We attempted to create a system for predicting recurrence of EGC after R0 resection.

METHODS: From January 1987 to April 2005, 2,923 patients with EGC who underwent curative resection were retrospectively studied. Of them, 79 patients (2.7%) experienced recurrence. Logistic regression was performed to identify independent risk factors for overall recurrence and early recurrence (recurred within 24 months after resection) of EGC. A nomogram was developed on the basis of a Cox regression.

RESULTS: Median time to recurrence was 20.5 months, and early recurrence accounted for 60.7% of instances. Presence of lymph node metastasis and elevated gross type were independent risk factors for overall recurrence; patients with both identified risk factors had a higher recurrence rate than average level (17.5% vs. 2.7%, P < 0.001). Meanwhile, male gender, elevated gross type, and presence of lymph node metastasis were significantly associated with early recurrence, and in patients with all of the aforementioned identified risk factors, the early recurrence rate was higher (12.2% vs. 1.6%, P < 0.001). A nomogram for predicting the disease-free survival after operation was constructed. Its c-index was 0.79 and it appeared to be accurate.

CONCLUSIONS: Recurrence of EGC after curative resection can be predicted by using common clinical characteristics. Patients at high risk of overall and early recurrence could be identified; individual disease-free survival was predictable by the internally validated nomogram
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
Yonsei Authors
Kim, Ki Yeol(김기열) ORCID logo https://orcid.org/0000-0001-5357-1067
Kim, Sung Soo(김성수)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Oh, Sung Jin(오성진)
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Choi, Seung Ho(최승호) ORCID logo https://orcid.org/0000-0002-9872-3594
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