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Risk Factors and Risk Scores for Predicting Early Recurrence After Curative Gastrectomy in Patients with Stage III Gastric Cancer

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

We revealed patients with pathological stage (pStage) III gastric cancer (GC) who had early recurrence within 12 months after curative surgery. We identified risk factors for predicting early recurrence in patients with pStage III GC who underwent curative gastrectomy.

Methods

Between January 2007 and December 2016, 758 patients underwent gastrectomy in our institution. This retrospective study included 96 patients with pStage III who were divided into two groups: early recurrence within 12 months (ERec) and non-ERec (nERec). We investigated clinicopathological differences between ERec and nERec and extracted risk factors, and constructed risk scores for ERec.

Results

Of the 96 patients, 20 (20.8%) were ERec and 76 (79.2%) were nERec. Pathological lymph node metastasis (pN) ≥ 14 (P = 0.03), preoperative carbohydrate antigen 19-9 (CA19-9) ≥ 37 IU/ml (P = 0.02), and blood loss (BL) ≥ 445 ml (P < 0.01) were independent risk factors for ERec in the multivariate analysis. In subgroup analysis, tumor size, clinical lymph node metastasis (cN), and CA19-9 were extracted for preoperative predictors for ERec. Risk scores were assigned to tumor size (< 65 mm, 0; ≥ 65 mm, 1), cN (cN−, 0; cN+, 2), and CA19-9 (< 37 IU/ml, 0; ≥ 37 IU/ml, 2). High-risk group (score, 4, 5) for ERec had significantly shorter relapse-free survival than those with low-risk group (score, 0–3) (P = 0.02).

Conclusions

We found pN ≥ 14, CA19-9 ≥ 37 IU/ml, and BL ≥ 445 ml were independent risk factors for ERec after curative gastrectomy in pStage III GC. Our risk score system may be useful to select patients with high risk of ERec preoperatively.

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Authors and Affiliations

  1. Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

    Kohei Wakatsuki, Sohei Matsumoto, Kazuhiro Migita, Tomohiro Kunishige, Hiroshi Nakade, Shintaro Miyao & Masayuki Sho

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  1. Kohei Wakatsuki
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  2. Sohei Matsumoto
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  3. Kazuhiro Migita
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  4. Tomohiro Kunishige
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  5. Hiroshi Nakade
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  6. Shintaro Miyao
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  7. Masayuki Sho
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Corresponding author

Correspondence to Kohei Wakatsuki.

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All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) as well as the 1964 Declaration of Helsinki and later versions. Informed consent was obtained from all patients to be included in the study.

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The authors declare that they have no conflict of interest.

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Wakatsuki, K., Matsumoto, S., Migita, K. et al. Risk Factors and Risk Scores for Predicting Early Recurrence After Curative Gastrectomy in Patients with Stage III Gastric Cancer. J Gastrointest Surg 24, 1758–1769 (2020). https://doi.org/10.1007/s11605-019-04327-5

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  • DOI: https://doi.org/10.1007/s11605-019-04327-5

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