Abstract
The purpose of this study was to review the risk factors of recurrence of early gastric cancer. Between 1974 and 1997 1013 patients with early gastric cancer underwent surgical resection in our department, and 24 of them (2.4%)(one of the 455 [0.2%] with mucosal cancer, 23 of the 558 [4.1%] with submucosal cancer) had a recurrence. The 24 patients were analyzed with regard to location of the recurrence and postoperative interval to the recurrence, and they were compared with the no-recurrence group in terms of sex, age, location, gross appearance, tumor size, operative procedures, histology, depth of invasion, INF, lymph-vascular invasion, lymph node involvement, and multiple lesion. Analysis using the chi-square test suggested that large tumor size, undifferentiated type, submucosal invasion, positivity for lymph-vascular invasion, lymph node metastasis, and multiple lesions were significantly related to recurrence. On the other hand, analysis by logistic regression suggested that undifferentiated type, submucosal invasion, lymph node metastasis, and multiple lesions were significantly related to recurrence. It also suggested that among early gastric cancers, those with 2 of the 4 risk factors (submucosal invasion, undifferentiated type, lymph node metastasis, and multiple lesions) had a greater tendency to recur by a hematogenous spread, and that those with upper 3 risk factors should be treated as an advanced cancer such as D2 lymph node dissection and adjuvant chemotherapy.
