4050 Background: Clinical outcome of long-term follow-up after 5 years of gastrectomy, such as recurrence or survival rate, recurrence patterns, and prognosticators, have not been studied well. We evaluated long-term natural history of gastric cancer with a median follow up duration of 15 years after D2–3 resection and adjuvant chemotherapy at a single institution. Especially in survived patients after 5 years of surgery, we analyzed risk factors for recurrence or survival. Methods: A total of 525 patients with stage IB to IVM0 (AJCC 2002) were accrued between 1984 and 1996. As a standard surgery, radical gastrectomy with D2–3 lymphadenectomy was performed. All the patients had adjuvant 5-FU plus adriamycin chemotherapy and 160 of them had also immunotherapy with poly A:U. Results: The median follow-up duration was 191 months. 15 patients (2.9%) were lost to follow-up with median follow-up of 45 months. 15-year disease-free and overall survival rates were 49.5% and 42.9%, respectively. In survivors after 5 years, recurrence rate was 16.0% (11.3% between 5 and 10 years; 4.7% after 10 years). The dominant recurrence patterns were distant metastasis (29.0%) between 5 and 10 years and secondary cancer (53.9%) after 10 years of surgery. Stage (IB vs II vs IIIA vs IIIB vs IVM0) was a clear-cut prognosticator during 5 years of gastrectomy, but its significance was lost between 5 to 10 years. At this time, only stage IVM0 was a significant poor prognosticator for gastric cancer-specific recurrence (HR = 6.61; P = 0.000) and cancer-specific death (HR = 7.04, P = 0.000). However, stage did not represent any significance after 10 years of surgery. Conclusions: In gastric carcinoma with D2–3 resection and adjuvant treatment, late recurrences after 5 years of surgery were not rare. Prognosticators were different in survivors after 5-years, 5–10 years and more than 10 years of surgery. No significant financial relationships to disclose.
S0030 Roux-En-Y Gastric Bypass Is Associated With Higher Rates of Pancreatic Cysts and Pancreatic Adenocarcinoma When Compared to Laparoscopic Sleeve Gastrectomy: Findings of a Nationwide Analysis With Long-Term Follow-Up
