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Perineural Invasion and Postoperative Complications are Independent Predictors of Early Recurrence and Survival Following Curative Resection of Gastric Cancer

Authors Chen L, Lin J, Chen LZ, Chen Y, Wang XJ, Guo ZQ, Yu JM

Received 27 May 2020

Accepted for publication 3 August 2020

Published 21 August 2020 Volume 2020:12 Pages 7601—7610

DOI https://doi.org/10.2147/CMAR.S264582

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Sanjeev Srivastava


Ling Chen, Jing Lin, Li-Zhu Chen, Yu Chen, Xiao-Jie Wang, Zeng-Qing Guo, Jia-Mi Yu

Department of Abdominal Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, People’s Republic of China

Correspondence: Ling Chen
Department of Abdominal Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, 420 Fuma Road, Fuzhou, Fujian 350014, People’s Republic of China
Tel +86 13960828743
Email chenl05@fjzlhospital.com

Purpose: To investigate the clinicopathological and prognostic factors related to early gastric cancer recurrence after curative resection.
Patients and Methods: Between October 2006 and August 2018, a total of 149 patients with recurrence of gastric cancer/adenocarcinoma of the esophagogastric junction after curative resection were enrolled from our treatment group. A retrospective clinical analysis was performed on these patients with gastric cancer recurrence after curative resection.
Results: Among the 149 patients, 99 (66.4%) had only one recurrence pattern, and 50 (33.6%) had multiple recurrence patterns. The median recurrence-free survival (RFS) was 18.2 months (95% CI 15.0– 21.4). Ninety-four patients (63.1%) experienced early recurrence (recurrence within 24 months after curative resection), and 55 patients (36.9%) experienced late recurrence (recurrence beyond 24 months after curative resection). The univariate analysis showed that perineural invasion (P=0.002), depth of invasion (P=0.026), postoperative chemotherapy (P=0.036) and postoperative complications (P=0.004) were significant factors associated with early recurrence after curative resection for gastric cancer. Perineural invasion (P=0.003), postoperative chemotherapy (P=0.036) and postoperative complications (P=0.042) were independent factors associated with early recurrence after curative resection in the multivariate analysis. The survival analysis showed that perineural invasion (P=0.011) and postoperative complications (P=0.007) were independent prognostic factors. The median survival time of early recurrence patients was significantly shorter than that of late recurrence patients (25.4 vs 62.9 months, P< 0.001).
Conclusion: Perineural invasion, postoperative chemotherapy and postoperative complications were independent factors associated with early recurrence after curative resection. Patients with early recurrence after curative resection had poorer survival.

Keywords: stomach neoplasms, gastrectomy, neoplasm recurrence and metastasis, prognosis

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