A clinicopathological analysis of tumor recurrence following curative surgery for gastric cancer. The results of an Italian Multicentric Study

The pattern of recurrence following curative surgery for gastric cancer was analyzed in 306 patients observed in two surgical Departments of Italy. Intestinal type and diffuse type of Lauren classification showed different patterns of dissemination, above all in the incidence of peritoneal carcinomatosis (9.8% vs. 30.1%). Multivariate analysis revealed that in intestinal type, nodal status, depth of invasion and male sex increase the risk of recurrence, whereas lymph node dissection (D2-D4 vs. D1) reduces such risk. In the diffuse type, depth of invasion, nodal status and tumor size was associated with higher recurrence rates; super-extended lymphadenectomy (D3-D4 vs. D1-D2) considerably reduced the risk of relapse, whereas no preventive effect was found for D2 vs. D1 dissection. These results suggest the use of different surgical and adjuvant treatment strategies for the two histotypes of gastric carcinoma.