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Background <p>Most recurrences of gastric cancer (GC) occur within 2&#xa0;years after curative gastrectomy, whereas late recurrence (≥ 3&#xa0;years) has been less well studied. We aimed to clarify the clinicopathologic characteristics, recurrence patterns, and outcomes of late recurrence.</p> Methods <p>We retrospectively analyzed 8094 patients who underwent gastrectomy for GC at a single high-volume center between 2005 and 2024. Among 691 patients with recurrence, clinicopathologic features, recurrence patterns, and post-recurrence survival (PRS) were compared between early (&lt; 3&#xa0;years) and late (≥ 3&#xa0;years) groups.</p> Results <p>Of 691 patients with recurrence, 104 (15.0%) developed late recurrence. Compared with early recurrence, the late recurrence group had a lower proportion of patients aged ≥ 75&#xa0;years (9.6% vs. 18.6%). Late recurrence was more often observed in patients with carcinoembryonic antigen (CEA) ≤ 5&#xa0;ng/mL (90.4% vs. 77.7%), carbohydrate antigen 19–9 (CA19-9) ≤ 37 U/mL (89.4% vs. 80.1%), pT1–2 stage (26.0% vs. 15.8%), and pN0 status (26.0% vs. 13.6%). Recurrence patterns differed by timing: 94.7% of hepatic recurrences developed within 3&#xa0;years, while peritoneal, nodal, and bone recurrences remained relatively common beyond 3&#xa0;years. Multivariate analysis of clinicopathologic factors associated with late recurrence identified CEA ≤ 5&#xa0;ng/mL, pT1–2, pN0, and lymphatic invasion as significant characteristics. PRS did not differ significantly between the groups (5-year PRS: 10.4% vs. 9.4%, <i>p</i> = 0.096).</p> Conclusions <p>Late recurrence accounted for 15% of all recurrences after curative gastrectomy. It was characterized by relatively early-stage disease features and distinct recurrence patterns, but survival after recurrence was comparable to that of early recurrence.</p>

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Clinicopathologic features and prognostic impact of late recurrence after gastrectomy for gastric cancer

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Kensuke Kudou,
  • Tomoyuki Irino,
  • Motonari Ri,
  • Masaru Hayami,
  • Souya Nunobe

摘要

Background

Most recurrences of gastric cancer (GC) occur within 2 years after curative gastrectomy, whereas late recurrence (≥ 3 years) has been less well studied. We aimed to clarify the clinicopathologic characteristics, recurrence patterns, and outcomes of late recurrence.

Methods

We retrospectively analyzed 8094 patients who underwent gastrectomy for GC at a single high-volume center between 2005 and 2024. Among 691 patients with recurrence, clinicopathologic features, recurrence patterns, and post-recurrence survival (PRS) were compared between early (< 3 years) and late (≥ 3 years) groups.

Results

Of 691 patients with recurrence, 104 (15.0%) developed late recurrence. Compared with early recurrence, the late recurrence group had a lower proportion of patients aged ≥ 75 years (9.6% vs. 18.6%). Late recurrence was more often observed in patients with carcinoembryonic antigen (CEA) ≤ 5 ng/mL (90.4% vs. 77.7%), carbohydrate antigen 19–9 (CA19-9) ≤ 37 U/mL (89.4% vs. 80.1%), pT1–2 stage (26.0% vs. 15.8%), and pN0 status (26.0% vs. 13.6%). Recurrence patterns differed by timing: 94.7% of hepatic recurrences developed within 3 years, while peritoneal, nodal, and bone recurrences remained relatively common beyond 3 years. Multivariate analysis of clinicopathologic factors associated with late recurrence identified CEA ≤ 5 ng/mL, pT1–2, pN0, and lymphatic invasion as significant characteristics. PRS did not differ significantly between the groups (5-year PRS: 10.4% vs. 9.4%, p = 0.096).

Conclusions

Late recurrence accounted for 15% of all recurrences after curative gastrectomy. It was characterized by relatively early-stage disease features and distinct recurrence patterns, but survival after recurrence was comparable to that of early recurrence.