Lauren histologic type is the most important factor associated with pattern of recurrence following resection of gastric adenocarcinoma Journal Article
| Authors: | Lee, J. H.; Chang, K. K.; Yoon, C.; Tang, L. H.; Strong, V. E.; Yoon, S. S. |
| Article Title: | Lauren histologic type is the most important factor associated with pattern of recurrence following resection of gastric adenocarcinoma |
| Abstract: | Objective: To examine sites of initial recurrence in patients after resection of gastric and gastroesophageal junction Siewert II/III adenocarcinoma (GA). Background: There are few recent studies on recurrence for Western patients following potentially curative resection of GA. Methods: A review of a prospectively maintained, single institution database was performed. Clinicopathologic factors, site(s) of initial recurrence, disease-free survival, and overall survival were examined. Results: From January 2000 to June 2010, 957 patients underwent potentially curative resection for GA, 435 patients (46%) had recurrent disease, and complete data on recurrence site(s) could be obtained in 386 patients. Tumors were Lauren intestinal type in 206 (53%) and diffuse or mixed-type in 180 (47%). Median time to recurrence was 12 months and 75% of recurrences occurred within 2 years. There was a significant difference in pattern of initial recurrence between the intestinal and diffuse/mixed cohorts (P < 0.001). For intestinal tumors, distant metastasis was the most common site (54%), followed by locoregional (20%), peritoneal (15%), and multifocal (11%). For diffuse/mixed tumors, peritoneal recurrence was the most common (37%), followed by distant (32%), locoregional (22%), and multifocal (9%). On multivariate analysis, Lauren histologic type was the only significant factor that was associated with both peritoneal recurrence (diffuse, hazard ratio 2.22, confidence interval 1.38-3.94) and distant recurrence (intestinal, hazard ratio 1.888, confidence interval 1.202-2.966). After recurrence, median overall survival was only 8.4 months. Conclusions: In GA patients who recur after resection, patterns of recurrence vary significantly based on Lauren histologic type. © 2016 Wolters Kluwer Health, Inc. |
| Keywords: | adult; aged; aged, 80 and over; disease-free survival; middle aged; cancer surgery; survival rate; retrospective studies; young adult; major clinical study; overall survival; clinical feature; cancer localization; cancer recurrence; united states; disease free survival; cancer staging; neoplasm staging; adenocarcinoma; neoplasm recurrence, local; incidence; recurrence; pathology; retrospective study; risk factor; histology; distant metastasis; tumor recurrence; recurrent disease; gastrectomy; multivariate analysis; epidemiology; esophageal adenocarcinoma; stomach adenocarcinoma; intestine tumor; stomach neoplasms; stomach tumor; esophagogastric junction; gastric adenocarcinoma; trends; peritoneum; gastroesophageal junction; procedures; very elderly; humans; human; male; female; priority journal; article; lauren type; lauren histology type |
| Journal Title: | Annals of Surgery |
| Volume: | 267 |
| Issue: | 1 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2018-01-01 |
| Start Page: | 105 |
| End Page: | 113 |
| Language: | English |
| DOI: | 10.1097/sla.0000000000002040 |
| PUBMED: | 27759618 |
| PROVIDER: | scopus |
| PMCID: | PMC5515689 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 6 February 2018 -- Source: Scopus |
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