Annals of Surgical Oncology

, Volume 17, Issue 2, pp 448–454 | Cite as

Recurrence After Curative Resection of Early Gastric Cancer

  • Ho Geun Youn
  • Ji Yeong An
  • Min Gew Choi
  • Jae Hyung Noh
  • Tae Sung Sohn
  • Sung Kim
Gastrointestinal Oncology



Few studies have evaluated the recurrence of EGC after curative gastrectomy, due to its relatively low incidence. This study evaluated recurrence patterns and independent predictive factors for recurrence in order to determine appropriate follow-up and early detection of recurrence.


We reviewed the medical records of 3,883 consecutive patients who underwent curative gastrectomy for EGC at Samsung Medical Center between February 1995 and January 2006 and were followed up until January 2008. The clinical and pathological characteristics and the predictive factors for recurrence were evaluated retrospectively.


Eighty-five (2.2%) patients had recurrence, and liver was the most common site of recurrence (45.9%). The recurrence rates within 2, 3, and 5 years were 43.5%, 67.1%, and 85.6%, respectively. There were 106 overall recurrences, with 86 (81.1%) being detected by computed tomography (CT). Second primary cancer was the primary cause of death after gastrectomy, followed by recurrence. Old age (>60 years), tumor size (>3 cm), multiple tumor, N category, and N2 station metastasis were significant factors for recurrence by multivariate analysis, but depth of invasion was not a significant factor.


Age, tumor size, number of tumors, N category, and N2 station metastasis were predictive factors for recurrence, with lymph node metastasis being the most significant factor. After curative gastrectomy, follow-up programs should be applied for more than 5 years for EGC patients, and computed tomography could be an essential diagnostic tool.


Gastric Cancer Positron Emission Tomography Primary Cancer Advanced Gastric Cancer Chest Radiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    2004 Nationwide Gastric Cancer Report in Korea. J Korean Gastric Cancer Assoc. 2007;7:47–54.Google Scholar
  2. 2.
    Basili G, Nesi G, Barchielli A, Manetti A, Biliotti G. Pathologic features and long-term results in early gastric cancer: report of 116 cases 8–13 years after surgery. World J Surg. 2003;27:149–52.PubMedGoogle Scholar
  3. 3.
    Borie F, Millat B, Fingerhut A, Hay JM, Fagniez PL, De Saxce B. Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. Arch Surg. 2000;135:1218–23.CrossRefPubMedGoogle Scholar
  4. 4.
    Gunji Y, Suzuki T, Hori S, Hayashi H, Matsubara H, Shimada H, et al. Prognostic significance of the number of metastatic lymph nodes in early gastric cancer. Dig Surg. 2003;20:148–53.CrossRefPubMedGoogle Scholar
  5. 5.
    Kunisaki C, Shimada H, Takahashi M, Ookubo K, Moriwaki Y, Akiyama H, et al. Prognostic factors in early gastric cancer. Hepatogastroenterology. 2001;48:294–8.PubMedGoogle Scholar
  6. 6.
    Lee HJ, Kim YH, Kim WH, Lee KU, Choe KJ, Kim JP, et al. Clinicopathological analysis for recurrence of early gastric cancer. Jpn J Clin Oncol. 2003;33:209–14.CrossRefPubMedGoogle Scholar
  7. 7.
    Sano T, Sasako M, Kinoshita T, Maruyama K. Recurrence of early gastric cancer. Follow-up of 1475 patients and review of the Japanese literature. Cancer. 1993;72:3174–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Shimada S, Yagi Y, Shiomori K, et al. Characterization of early gastric cancer and proposal of the optimal therapeutic strategy. Surgery. 2001;129:714–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Kunisaki C, Akiyama H, Nomura M, et al. Significance of long-term follow-up of early gastric cancer. Ann Surg Oncol. 2006;13:363–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Sobin LH, Wittekind CH, editors. UICC (International union against cancer), TNM classification of malignant tumors. 6th ed. 2002.Google Scholar
  11. 11.
    Japanese Gastric Cancer A. Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRefGoogle Scholar
  12. 12.
    Kikuchi S, Katada N, Sakuramoto S, Kobayashi N, Shimao H, Watanabe M, et al. Survival after surgical treatment of early gastric cancer: surgical techniques and long-term survival. Langenbecks Arch Surg. 2004;389:69–74.CrossRefPubMedGoogle Scholar
  13. 13.
    Kim DY, Joo JK, Ryu SY, Kim YJ, Kim SK. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma. World J Gastroenterol. 2004;10:737–40.PubMedGoogle Scholar
  14. 14.
    Kunisaki C, Shimada H, Nomura M, Akiyama H. Appropriate lymph node dissection for early gastric cancer based on lymph node metastases. Surgery. 2001;129:153–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Saito H, Osaki T, Murakami D, et al. Recurrence in early gastric cancer–presence of micrometastasis in lymph node of node negative early gastric cancer patient with recurrence. Hepatogastroenterology. 2007;54:620–4.PubMedGoogle Scholar
  16. 16.
    Yuasa N, Nimura Y. Survival after surgical treatment of early gastric cancer, surgical techniques, and long-term survival. Langenbecks Arch Surg. 2005;390:286–93.CrossRefPubMedGoogle Scholar
  17. 17.
    D’Angelica M, Gonen M, Brennan MF, Turnbull AD, Bains M, Karpeh MS. Patterns of initial recurrence in completely resected gastric adenocarcinoma. Ann Surg. 2004;240:808–16.CrossRefPubMedGoogle Scholar
  18. 18.
    Yoo CH, Noh SH, Shin DW, Choi SH, Min JS. Recurrence following curative resection for gastric carcinoma. Br J Surg. 2000;87:236–42.CrossRefPubMedGoogle Scholar
  19. 19.
    Otsuji E, Kuriu Y, Ichikawa D, Okamoto K, Hagiwara A, Yamagishi H. Tumor recurrence and its timing following curative resection of early gastric carcinoma. Anticancer Res. 2003;23:3499–503.PubMedGoogle Scholar
  20. 20.
    Yamamoto M, Yamanaka T, Baba H, Kakeji Y, Maehara Y. The postoperative recurrence and the occurrence of second primary carcinomas in patients with early gastric carcinoma. J Surg Oncol. 2008;97:231–5.CrossRefPubMedGoogle Scholar

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Ho Geun Youn
    • 1
  • Ji Yeong An
    • 2
  • Min Gew Choi
    • 3
  • Jae Hyung Noh
    • 3
  • Tae Sung Sohn
    • 3
  • Sung Kim
    • 3
  1. 1.Department of SurgerySeoul Veterans HospitalSeoulKorea
  2. 2.Department of SurgeryYonsei University College of MedicineSeoulKorea
  3. 3.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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