BACKGROUND: The prognosis for patients with stage Ib (second English edition of the Japanese classification of gastric carcinoma) gastric cancer is promising, with an expected 5-year survival of 90%. Despite this relatively high survival rate, the outcome for patients who experience recurrence is poor. To date, however, prognostic and recurrence factors for stage Ib gastric cancer are poorly understood, and appropriate adjuvant chemotherapy protocols have not been developed. METHODS: We retrospectively analyzed data from 86 stage Ib gastric cancer patients who underwent curative gastrectomy to determine the rates and predictive factors of recurrence. RESULTS: Eleven patients showed recurrence, with a 12.8% 5-year cumulative recurrence rate. Nearly all of these patients were initially histologically diagnosed with poorly differentiated adenocarcinoma. Based on univariate analyses, recurrence was associated with gender and histological type. Multivariate analyses revealed that the only independent risk factor for recurrence was histologically undifferentiated-type adenocarcinoma. The 5-year survival rate of patients with undifferentiated-type adenocarcinoma was 84%. The predominant recurrence pattern was peritoneal dissemination, and was typically observed 1-3 years post-resection. CONCLUSION: This retrospective study identified undifferentiated-type adenocarcinoma as the only risk factor for recurrence in stage Ib gastric cancer patients. Although randomized controlled studies are necessary, stage Ib gastric cancer patients with this identified recurrence risk factor would be candidates for adjuvant chemotherapy.
BACKGROUND: The prognosis for patients with stage Ib (second English edition of the Japanese classification of gastric carcinoma) gastric cancer is promising, with an expected 5-year survival of 90%. Despite this relatively high survival rate, the outcome for patients who experience recurrence is poor. To date, however, prognostic and recurrence factors for stage Ib gastric cancer are poorly understood, and appropriate adjuvant chemotherapy protocols have not been developed. METHODS: We retrospectively analyzed data from 86 stage Ib gastric cancerpatients who underwent curative gastrectomy to determine the rates and predictive factors of recurrence. RESULTS: Eleven patients showed recurrence, with a 12.8% 5-year cumulative recurrence rate. Nearly all of these patients were initially histologically diagnosed with poorly differentiated adenocarcinoma. Based on univariate analyses, recurrence was associated with gender and histological type. Multivariate analyses revealed that the only independent risk factor for recurrence was histologically undifferentiated-type adenocarcinoma. The 5-year survival rate of patients with undifferentiated-type adenocarcinoma was 84%. The predominant recurrence pattern was peritoneal dissemination, and was typically observed 1-3 years post-resection. CONCLUSION: This retrospective study identified undifferentiated-type adenocarcinoma as the only risk factor for recurrence in stage Ib gastric cancerpatients. Although randomized controlled studies are necessary, stage Ib gastric cancerpatients with this identified recurrence risk factor would be candidates for adjuvant chemotherapy.
Authors: Byunghyuk Yu; Ji Yeon Park; Ki Bum Park; Oh Kyoung Kwon; Seung Soo Lee; Ho Young Chung Journal: J Gastric Cancer Date: 2020-09-23 Impact factor: 3.720
Authors: Victor Hugo Fonseca de Jesus; Wilson Luiz da Costa; Tiago Cordeiro Felismino; Vinicius Fernando Calsavara; Alessandro Landskron Diniz; Heber Salvador de Castro Ribeiro; André Luis de Godoy; Igor Correia de Farias; Felipe José Fernandez Coimbra Journal: J Gastrointest Oncol Date: 2019-12