Abstract
Background
The value of programs to detect recurrence of a previously operated gastric cancer is a controversial subject. D2 lymphadenectomy achieves better local control and a lower local recurrence rate than D1 lymphadenectomy.
Methods
The results achieved with surgical treatment of recurrent gastric cancer in a series of 126 consecutive patients who had been treated with gastrectomy with D2 lymphadenectomy are reported. In-hospital mortality was 1.6%.
Results
Follow-up of the remaining 124 patients for a median period of 73.6 months detected recurrence in 46 patients (37%). There were 14 local, 12 peritoneal, and 15 distant recurrences. Recurrent gastric cancer was detected within 2 years in 76% of the patients. Of the 46 patients with recurrence, 5 patients (11%) were selected for surgery (4 local and 1 peritoneal recurrence). The median disease-free time after surgery for recurrence was 26 months (range, 14–58 months). There was no in-hospital mortality. The median survival time after surgery for recurrence was 26 months (range, 9–87 months). One patient died during follow-up, while none of the other patients have any evidence of new recurrence.
Conclusion
Surgery for recurrent gastric cancer is a valid alternative in selected patients, provided it is performed by specialized work teams.
Article PDF
Similar content being viewed by others
References
Bohner H, Zimmer Th, Hopfenmuller W, Berger G, Buhr H. Detection and prognosis of recurrent gastric cancer. Is routine follow-up after gastrectomy worthwhile? Hepatogastroenterology 2000;47:1489–1494.
Bennett J, Gonen M, D’Angelica M, Jacques D, Brennan M, Coit D. Is detection of asymptomatic recurrence after curative resection associated with improved survival in patients with gastric cancer? J Am Coll Surg 2005;201:503–510.
Schwarz R, Zagala-Nevarez K. Recurrence patterns after radical gastrectomy for gastric cáncer: factors and implications for postoperative adjuvant therapy. Ann Surg Oncol 2002;9:394–400.
D’Angelica M, Gonen M, Brennan M, Turnbull A, Bains M, Karpeh S. Patterns of initial recurrence in completely resected gastric adenocarcinoma. Ann Surg 2004;240:808–816.
Yoo C, Noh S, Shin D, Choi S, Min J. Recurrence following curative resection from gastric carcinoma. Br J Surg 2000;87:236–242.
Roukos D, Kappas A. Limitations in controlling risk for recurrence after curative surgery for advanced gastric cancer are now well-explained by molecular-based mechanisms. Ann Surg Oncol 2001;8:620–621.
Kappas A, Roukos D. Quality of surgery determinant for the outcome of patient with gastric cancer. Ann Surg Oncol 2002;9:828–830.
Maehara Y, Hasuda S, Koga T, Tokunaga E, Kakeji Y, Sugimachi K. Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer. Br J Surg 2000;87:353–357.
Averbach A, Jacquet P. Strategies to decrease the incidence of intra-abdominal recurrence in resectable gastric cancer. Br J Surg 1996;83:726–733.
Marrelli D, Roviello F, de Manzoni G, Morgagni P, Di Leo A, Saragoni L, et al. Different patterns of recurrence in gastric cancer depending on Lauren’s histological type: longitudinal study. World J Surg 2002;26:1160–1165.
Lehnert T, Rudek B, Buhl K, Golling M. Surgical therapy for loco-regional recurrence and distant metastasis of gastric cancer. Eur J Surg Oncol 2002;28:455–461.
Fujii K, Fujioka S, Kato K, Machiki Y, Kutsuna Y, Ishikawa A, et al. Resection of liver metastasis from gastric adenocarcinoma. Hepatogastroenterology 2001;48:368–371.
Okano K, Maeba T, Ishimura K, Karasawa Y, Goda F Wakabayashi H, et al. Hepatic resection for metastatic tumors from gastric cancer. Ann Surg 2002;235:86–91.
Ambiru S, Miyasaki M, Hiroshi I, Nakagawa K, Shimizu H, Yoshidome H, et al. Benefit and limits of hepatic resection for gastric metastases. Am J Surg 2001;181:279–283.
Weitz J, Blumgart L, Fong Y, Jarnagin W, D’Angelica M, Harrison L, et al. Partial hepatectomy for metastases from noncolorectal nonneuroendocrine carcinoma. Ann Surg 2005;241:269–276.
Takeyoshi I, Ohwada S, Ogawa T, Kawashima Y, Ohya T, Kawate S, et al. The resection of non-hepatic intraabdominal recurrence of gastric cancer. Hepatogastroenterology 2000;47:1479–1481.
McGill FM, Ritter DB, Rickard DB, Kaleya CS, Wadler RN, Greston WM, et al. Krukenberg tumors: can management be improved? Gynecol Obstet Invest 1999;48:61–65.
Cheong JH, Hyung WJ, Chen J, Kim J, Choi SH, Noh SH. Survival benefit of metastasectomy for Krukenberg tumors from gastric cancer. Gynecol Oncol 2004;94:477–482.
Kim H, Heo D, Bang Y, Kim N. Prognostic factors of Krukenberg’s tumor. Gynecol Oncol 2001;82:105–109.
Wittekind CH, Greene FL, Hutter R, Klimpfingerand M, Sobin LH (eds.). TNM atlas: Illustrated guide to the TNM classification of malignant tumours. 5th ed. Heldelberg: Springer Verlag; 2005.
Shchepotin I, Evans SR, Shabahang M, Cherny V, Buras RR, Zadorozhny A. Radical treatment of locally recurrent gastric cancer. Am Surg 1995;61:371–376.
Guadagni S, Catarci M, Kinoshita T, Valenti M, Bernardinis G, Carboni M. Causes of death and recurrence after surgery for early gastric cancer. World J Surg 1997;21:434–439.
Marrelli D, De Stefano A, de Manzoni G, Morgagni P, Di Leo A, Roviello F. Prediction of recurrence after radical surgery for gastric cáncer. A scoring system obtained from a prospective multicenter study. Ann Surg 2005;241:247–255.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
De Liaño, Á.D., Yarnoz, C., Aguilar, R. et al. Surgical treatment of recurrent gastric cancer. Gastric Cancer 11, 10–14 (2008). https://doi.org/10.1007/s10120-007-0444-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10120-007-0444-5