Risk factors for recurrence of gastric cancer after curative laparoscopic gastrectomy

Introduction : Curative laparoscopic gastrectomy (LG) is associated with good outcomes when performed for early gastric cancers. The aim of this study was to identify risk factors for recurrence after LG. Methods : 212 patients with gastric cancer who underwent gastrectomy were enrolled (LG : 143, open gastrectomy, OG : 69). Univariate analysis was used to assess overall (OS) and disease-free survival (DFS) in LG and OG group. Multivariate analysis was used to assess risk factors for recurrence after LG. Results : In LG, six cases of recurrence were observed (liver : 2, peritoneum : 4). Neither lymph node nor port-site recurrences were evident after LG. The 5-year DFS after LGwas 91.4%. Based on univariate analysis of 5-year DFS, three negative prognostic factors-lymph node metastasis, lymphatic invasion, and venous invasion-were identified. The independent risk factor for recurrence of LG was lymph node metastasis. LG and OG showed no significant differences in 5-year DFS among Stage IA, IB, IIA, and IIB groups. Independent risk factors for recurrence after LG or OG were tumor invasion≥muscularis mucosa and lymph node metastasis. Conclusions : DFS following LG is comparable to that following OG. Lymph node metastasis is an independent risk factor for gastric cancer recurrence after LG.