In:
Annals of Saudi Medicine, King Faisal Specialist Hospital and Research Centre, Vol. 41, No. 6 ( 2021-11), p. 336-349
Abstract:
Predictors of recurrence in patients with lymph node-negative gastric cancer (GC) who have undergone curative resection have been widely investigated, but not the effects of predictors on timing of recurrence. OBJECTIVE: Determine the factors associated with early and late recurrence in patients with node-negative GC. DESIGN: Retrospective cohort. SETTING: Academic tertiary care center. PATIENTS AND METHODS: The study included patients with node-negative GC after curative resection between 2008 and 2018 at two institutions. Early and late recurrences were determined using a minimum P value approach to evaluate the optimal cutoff for recurrence-free survival (RFS). A competing risk model and landmark analysis were used to analyze factors associated with early and late recurrences. MAIN OUTCOME MEASURES: Recurrence-free survival and factors associated with survival. SAMPLE SIZE: 606. RESULTS: After a median follow-up of 70 months, 50 (8.3%) patients experienced recurrent disease. The optimal length of RFS for distinguishing between early (n=26) and late recurrence (n=24) was 24 months ( P =.0013). The median RFS in the early and late recurrence groups was 11 and 32 months, respectively. Diffuse tumors (hazard ratio 3.358, P =.014), advanced T stage (HR 8.804, P =.003), perineural invasion (HR 10.955, P 〈 .001), and anemia (HR 2.351, P =.018) were independent predictors of early recurrence. Mixed tumor location (HR 5.586, P =.002), advanced T stage (HR 5.066, P 〈 .001), lymphovascular invasion (HR 5.902, P 〈 .001), and elevated CA19-9 levels (HR 5.227, P 〈 .001) were independent predictors of late recurrence. Similar results were obtained in the landmark analysis. CONCLUSIONS: Individualized therapeutic and follow-up strategies should be considered in future studies because of distinct patterns in predictors of early and late recurrence. LIMITATIONS: Retrospective design, small sample size. CONFLICT OF INTEREST: None.
Type of Medium:
Online Resource
ISSN:
0256-4947
,
0975-4466
DOI:
10.5144/0256-4947.2021.336
Language:
English
Publisher:
King Faisal Specialist Hospital and Research Centre
Publication Date:
2021
detail.hit.zdb_id:
2022900-8
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