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Locoregional relapse after gastrectomy with D2 lymphadenectomy for gastric cancer

Authors
 J. S. Chang  ;  K. H. Kim  ;  H. I. Yoon  ;  W. J. Hyung  ;  S. Y. Rha  ;  H. S. Kim  ;  Y. C. Lee  ;  J. S. Lim  ;  S. H. Noh  ;  W. S. Koom 
Citation
 British Journal of Surgery, Vol.104(7) : 877-884, 2017 
Journal Title
 British Journal of Surgery 
ISSN
 0007-1323 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Chemotherapy, Adjuvant ; Female ; Follow-Up Studies ; Gastrectomy* ; Humans ; Lymph Node Excision* ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local* ; Risk Factors ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery* ; Survival Rate
Abstract
BACKGROUND: Risk for and site of locoregional relapse have not been well studied in patients undergoing gastrectomy with D2 lymphadenectomy for gastric cancer. METHODS: Patients who had undergone gastrectomy with D2 lymphadenectomy for gastric cancer between 2004 and 2007 were identified from an institutional database. The locoregional relapse rate was estimated by competing risk analysis, and risk groups were derived according to locoregional relapse risk using recursive partitioning analysis (RPA). The locations of nodal relapses were evaluated according to Japanese Classification of Gastric Carcinoma criteria. RESULTS: Some 2618 patients were included. With a median follow-up of 78·0 (range 28·5-122·6) months, relapse was diagnosed in 471 of 2618 patients (18·0 per cent). The cumulative incidence of locoregional relapse at 5 years was 8·5 (95 per cent c.i. 7·4 to 9·6) per cent. The 5-year locoregional recurrence rates for high-risk (N3), intermediate-risk (N1-2) and low-risk (N0) groups were 32·4, 12·3 and 1·7 per cent respectively (P < 0·001). Among patients with regional relapse, 90·4 per cent had involvement outside the D2 dissected area, and the most commonly involved site was station 16b1. This pattern was maintained in the RPA risk groups (P = 0·329). CONCLUSION: Locoregional relapse at 5 years after gastrectomy with D2 lymphadenectomy was 8·5 per cent, and was most often seen outside the D2 dissected area.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1002/bjs.10502
DOI
10.1002/bjs.10502
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
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
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
금웅섭(Koom, Woong Sub) ORCID logo https://orcid.org/0000-0002-9435-7750
김효송(Kim, Hyo Song) ORCID logo https://orcid.org/0000-0002-0625-9828
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
윤홍인(Yoon, Hong In) ORCID logo https://orcid.org/0000-0002-2106-6856
이용찬(Lee, Yong Chan)
임준석(Lim, Joon Seok) ORCID logo https://orcid.org/0000-0002-0334-5042
장지석(Chang, Jee Suk Paul) ORCID logo https://orcid.org/0000-0001-7685-3382
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160487
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