Analysis On The Factors Related With Post-operative Recurrence Of Advanced Gastric Cancer Patients

Background:Recently, gastric cancer is among one of the commonest neoplasm. Combined therapy based on radical resection has promoted the prognosis of gastric cancer, but the post-operative recurrence is still high, which is the main cause of death.Purpose:To find out the operative factors that cause the post-operative recurrence of gastric cancer patients.Materials and methods:We retrospectively studied 428 patients of advanced gastric cancer undergone radical resections in Huashan Hospital during 1997-1 to 2001-6.We used Kaplan-Meier survival analysis to analyze the post-operative survival rate of gastric cancer patients, and draw the survival curves; and we used log Rank single factor test analysis and COX regression multiple factor analysis to analyze the factors related with post-operative recurrence of advanced gastric cancer patients.Results:1. Among the 428 patients, 154 patients recurred (recurrence rate 35.90%), in which there were 50 cases with local recurrence(32.46%), 43 cases with blood metastasis (27.9%), 39 cases with abdominal cavity implantation(25.32%), 6 cases with distant lymph metastasis(3.89%) and 15 cases with multi-organ metastasis(9.74%).2. The 1 year survival rate was 91.6%, the 3 year survival rate was 56.9% and the 5 year survival rate was 45.4%. Median survival time was 52 months (CI 37.47 -58.28 months) and mean survival time was 60 months (CI 56.38-64.82 months) .3. Results of log Rank single factor test analysis showed that age, tumor size, Borrmann type, pTN stage and differentiation were the correlated factors of gastric cancer recurrence after radical resection, while sex, tumor location, surgery type and pathological type were not. 4. Results of COX regression multiple factor analysis showed that tumor size and pTN stage were the independent factors of gastric cancer recurrence after radical resection, while age, sex, Borrmann type, tumor location, surgery type, differentiation and pathological type were not.Conclusions:Post-operative recurrence of advanced gastric cancer is still on a high level. Recurrence is the main cause of death, and mainly happens in 2 years after surgery. Age, tumor size, Borrmann type, pTN stage and differentiation are the correlated factors of gastric cancer recurrence after radical resection by log Rank single factor test analysis. And tumor size and pTN stage are the independent factor of gastric cancer recurrence after radical resection by COX regression multiple factor analysis.