Surgical Oncology 1992; 1: 341-346

Risk factors which predict pattern of recurrence after curative surgery for patients with advanced gastric cancer S. MORIGUCHI*, Y. MAEHARAT, D. KORENAGAt,

K. SUGlMACHlt

AND Y. NOSE*

The Departments of *Medical lnformatics and tSurgery II, Faculty of Medicine, Kyushu University, Japan

The objective

of the study was to define

haematogenous

metastasis

after

gastric

cancer.

In retrospective

rence.

Patients

who

tumours

which invasion

(35.7%)

were

by gastric secondary

mine the independent nous metastasis, serosal

invasion

(P< 0.01,

cancerous

metastasis.

Keywords:

gastric

dissemination,

cancer,

related

logistic

haematogenous

metastasis,

tion

of patients

several toneal

liver,

tumour

edge

of

of

bone node

clinico-pathological recurrence

12, 5-81.

a poor

Medical

Informatics,

60, 3-1-1, Maidashi,

Sunao

Moriguchi,

Faculty Higashi-ku,

risk factors

for a haema-

analysis,

peritoneal

MD,

of Medicine,

and

with

of fatal

resection,

interactions

using

between

independent

gastric

risk fac-

stepwise

peritoneal

metastasis, cancer

to

liver

[9]. In the

recurrence:

haematogenous

‘advanced’

or

of recurrence

determined

we

regard

after

logistic

for ‘cura-

regression

PATIENTS

AND

METHODS

prognoPatients

and

For this

already

Department

Kyushu

further

to a pattern pattern

with

dissemination

analysis.

during

characteristics have

risk factors

the

a close associa-

We

study,

retrospective

consecutively Correspondence:

of

and

frequently

noted

present

tive’

metastasis from

related

patients

intraoperatively

and signify

investigators

relative by

to examine

factors

dissemination

A local

dissemination

occur

that

of vessel invasion

peritoneal

tors for each

peri-

metasta[I].

clearance

Peritoneal

follow-up

sis [3, 41. Many

and

of lymph

spread

postoperative tion between

haematogenous

margin [2].

cancer,

recurrence,

predicted

on the extent

resec-

gastric

local

brain

be

resection

haematogenous

pattern

and

suggested The presence

the independent

metastasis

the route of

curative

an advanced

lung,

may

depending

to determine cells after

are evident;

dissemination

recurrence the

with

patterns

sis to the

or

clinically

by cancerous

to

To deter-

4 (PC 0.01,

multivariate

reported

it is difficult

related

pattern.

synchronous metastasis

type

60

1992; 1: 341-346.

INTRODUCTION While

and

and haematoge-

model

dissemination.

the greatest

recurinvasive

nodes,

were

dissemination

risk = 2.62) and presence

Oncology

large,

to lymph

and

advanced

Of the 168 deaths,

53 (31.5%)

and Borrmann

risk = 1.59) were

an

to a local recurrence.

for peritoneal

(P < 0.01, relative

recurrence

metastasized

to peritoneal

risk = 2.57)

with

to have

or P 0.1) (Table 1).

secondary

rank-sum

RESULTS

At the time

sex, age, and

the

Mann-Whitney

haematogenous

univariate

gastric

to the patients’

procedures

therapy

gastric

recurrent

to age, sex, pathological

discerned

Clinico-pathological

of

and

than

the data were

likely

However,

those

analyses,

metastasis,

or

P