| Abstract: | The incidence and mortality of gastric cancer (GC) have dramatically declined for the last several decades, and the therapeutic outcomes of patients with GC continue to improve. Nonetheless, GC remains a major public health issue as the fourth most common cancer and a relevant problem as the second most common cause of cancer death worldwide.1, 2] The highest incidence rates are in Eastern Asia, Eastern Europe, and South America.3] Presently, the only potentially curative treatment for GC is radical gastrectomy. Despite curative resection (R0), recurrences are still common, occurring in approximately 60% of patients. The main reason for this is that GC is often advanced at the time of diagnosis.4-6] Death from GC after curative resection is mostly due to recurrence as well. The GC recurrence rates after curative resection are not uniform as reported,7] and the recurrence rates at different time points after surgery are quite different from one another. More than 90% of patients relapse within 5 years after surgery, and 70% relapse within 2 years. In a study by Wu et al.,8] cumulative recurrence rates were 53.5%, 80%, 89.0%, 94.7%, 96.3%, 98%, and 99.5% at 1, 2, 3, 4, 5, 6, and 7 years, respectively. The long-term recurrence rate at 7 years was 15.8% for locoregional relapse and 34.5% for distant recurrence in a recent study.4] These high rates of recurrence have been attributed to the abundant lymphatic channels within the gastric wall, providing channels for mucosal skip lesions and numerous potential pathways of lymphatic drainage away from the stomach.9] Both the recurrence rate and recurrence pattern following laparoscopic gastrectomy were similar to those of conventional laparotomy according to a multicenter study.10] This article reviews the current clinical status and progress of recurrence from GC following radical gastrectomy by concentrating on the patterns of recurrence, clinicopathologic factors affecting recurrence, detection of recurrence, prognosis, and treatment methods. |
