Improving a follow-up plan based on the tumor deposits status and recurrence pattern of stage Ⅱ/Ⅲ gastric cancer patients after radical gastrectomy
10.3760/cma.j.cn113855-20240325-00214
- VernacularTitle:基于癌结节状态及复发模式改良Ⅱ/Ⅲ期胃癌患者根治术后随访计划的研究
- Author:
Kelei HUA
1
;
Mingke HUO
;
Zhichuang DONG
;
Sen LI
;
He ZHANG
;
Yingkun REN
;
Yi CAO
Author Information
1. 郑州大学附属肿瘤医院 河南省肿瘤医院普外科，郑州 450008
- Keywords:
Stomach neoplasms;
Recurrence;
Follow-up studies;
Tumor deposits
- From:
Chinese Journal of General Surgery
2024;39(10):783-789
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between cancer node status identified after radical resection and patterns of recurrence in stage Ⅱ/Ⅲ gastric cancer patients for developing personalized follow-up plans in node-positive patients.Methods:A retrospective analysis was conducted on 706 stage Ⅱ/Ⅲ gastric cancer patients who underwent curative intent surgery at Henan Cancer Hospital from Sep 2015 to Sep 2018. Patients were categorized into node-positive (TDs +) and node-negative (TDs -) groups based on their cancer node status. Clinical-pathological characteristics and recurrence patterns were compared between the groups to formulate an optimized follow-up plan. Results:Among the patients, there were 112 TDs + and 594 TDs - cases. TDs - patients exhibited significantly better overall survival and disease-free survival rates at 1 and 3 years compared to the TDs + group (92.4%,72.2% vs. 79.4%,38.8%;87.9%,68.6% vs. 66.7%,35.9%, all P<0.05). The cumulative recurrence rates of peritoneal and distant metastases were higher in TDs + patients compared to TDs - patients, with statistical significance (33.0% vs. 14.5%,21.4% vs. 10.8%, χ 2=21.285,8.851 all P<0.05). TDs + patients experienced significantly earlier median time to distant metastasis compared to TDs - patients (9.0 months vs. 15.4 months , Z=-2.294 P=0.022). The risk of peritoneal metastasis recurrence was higher in the TDs + group, showing a bimodal recurrence pattern at 8.5 and 15.0 months post-surgery. TDs + patients also had a higher risk of distant metastasis recurrence, with a single peak at 6 months. Conclusion:Postoperative recurrence patterns differ between TDs + and TDs - patients, and an optimized follow-up plan can enhance early detection of recurrence.
