Recurrence in node-negative advanced gastric cancer with novel clinical and pathologic findings

Background Node-negative gastric cancer patients carry a better prognosis than node-positive. However, a subset of these patients eventually died due to the high recurrence rate of recurrence. This study investigated the clinic-pathologic factors for recurrent patterns and prognosis. Methods The detailed medical records of 947 gastric cancer patients who underwent gastrectomy from the prospectively collected database of the Gastrointestinal Surgery Department of the First Affiliated Hospital of Zhejiang Chinese Medical University From January 2012 to December 2014 were analyzed retrospectively. Results Tumor size, tumor invasion, histological grading were the predictive factors for locoregional recurrence. Tumor invasion, histological grading, Lauren type and lymphatic vessel invasion resulted significantly in predicting peritoneal recurrence. Two parameters, tumor invasion and lymphatic vessel invasion, were significantly associated with hematogenous spread. The combinatorial biomarker of positive for both Ki67 and P53 was significantly associated with recurrence-free survival (RFS) (P = 0.037). Histological grading (P = 0.020), tumor invasion (P = 0.007) and lymphatic vessel invasion (P = 0.012) were independent factors related to overall survival (OS) in node-negative advanced gastric cancer patients. Conclusion The reported clinicopathologic factors for different recurrence patterns and the prognostic factors of RFS and OS should be considered to guide clinicians choose appropriate postoperative treatment strategy and construct individual follow-up schedule to improve prognosis of node-negative gastric cancer.