Clinical and Morphological Indicators of Early Gastric Cancer Recurrence

ORIGINAL ARTICLE
Ekaterina P. Anokhina, Evgeniy A. Toneev, Linar R. Zaripov, Alexander A. Martynov, Roman F. Shagdaleev, U. A. Ulyanova, A. D. Minacheva

 
For citation: Anokhina EP, Toneev EA, Zaripov LR, Martynov AA, Shagdaleev RF, Ulyanova UA, Minacheva AD. Clinical and Morphological Indicators of Early Gastric Cancer Recurrence. International Journal of Biomedicine. 2025;15(3):500-504. doi:10.21103/Article15(3)_OA6
 
Originally published September 5, 2025

Abstract: 

Background: Despite advancements in diagnostics and the widespread adoption of multimodal therapy for gastric cancer, early recurrence continues to pose a serious clinical challenge. This study aims to identify clinical, morphological, and perioperative factors associated with early recurrence (≤6 months) of gastric cancer after completion of combined treatment and to develop a prognostic model for assessing the risk of recurrence.
Methods and Results: This retrospective study included data from 199 patients who underwent gastrectomy with D2 lymph node dissection in a regional oncology center. A total of 88 patients who completed combined (multimodal) treatment were included in the final statistical analysis. Clinical and tumor-related characteristics, response to treatment, and surgical parameters were evaluated. Patients were divided into two groups based on the presence or absence of recurrence within 6 months. Logistic regression analysis was used to identify independent predictors. Model performance was assessed using ROC analysis.
Among the 88 patients included in the final analysis, disease recurrence was observed in 44 cases (50%). Of these, 21 patients (47.7%) experienced a recurrence within the first six months following completion of combined treatment. The multivariate analysis confirmed that poor tumor differentiation (G3) (OR = 6,084; 95% CI: 1,124–32,917) and the presence of lymphovascular invasion (OR = 9,902; 95% CI: 2,061–47,560) play a significant role in the likelihood of gastric cancer recurrence following the completion of combined treatment. The prognostic model demonstrated good discriminatory ability, with an AUC of 0.852 (95% CI: 0.735–0.969), sensitivity of 85.7%, and specificity of 73.9%.
Conclusion: Lymphovascular invasion and poor tumor differentiation may serve as independent risk factors for recurrence within the first six months following completion of combined treatment for gastric cancer. The developed model may be helpful in stratifying risk and personalizing postoperative surveillance.

Keywords: 
gastric cancer • treatment • risk of recurrence • prognostic model
References: 
  1. Shakhzadova AO, Starinsky VV, Lisichnikova IV. [The state of oncological care for the population of Russia in 2022]. Siberian Oncological Journal. 2023;22(5):5–13. [Article in Russian]. doi: 10.21294/1814-4861-2023-22-5-5-13
  2. Malignant neoplasms in Russia in 2022 (morbidity and mortality) / Ed. by A.D. Kaprin et al. Moscow: P.A. Herzen Moscow Oncology Research Institute – branch of the National Medical Research Center of Radiology, Ministry of Health of Russia, 2023. Illustrated. 275 p.[In Russian].
  3. Kang WM, Meng QB, Yu JC, Ma ZQ, Li ZT. Factors associated with early recurrence after curative surgery for gastric cancer. World J Gastroenterol. 2015 May 21;21(19):5934-40. doi: 10.3748/wjg.v21.i19.5934. PMID: 26019458; PMCID: PMC4438028.
  4. Jiao X, Wang Y, Wang F, Wang X. Recurrence pattern and its predictors for advanced gastric cancer after total gastrectomy. Medicine (Baltimore). 2020 Dec 18;99(51):e23795. doi: 10.1097/MD.0000000000023795. PMID: 33371151; PMCID: PMC7748337.
  5. Goldstraw P, Chansky K, Crowley J, Rami-Porta R, Asamura H, Eberhardt WE, Nicholson AG, Groome P, Mitchell A, Bolejack V; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee, Advisory Boards, and Participating Institutions; International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee Advisory Boards and Participating Institutions. The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer. J Thorac Oncol. 2016 Jan;11(1):39-51. doi: 10.1016/j.jtho.2015.09.009. PMID: 26762738.
  6. Pang HY, Yan MH, Chen LH, Chen XF, Chen ZX, Zhang SR, Sun H. Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis. Front Oncol. 2022 Oct 26;12:1011683. doi: 10.3389/fonc.2022.1011683. PMID: 36387075; PMCID: PMC9643694.
  7. Wu CW, Lo SS, Shen KH, Hsieh MC, Chen JH, Chiang JH, Lin HJ, Li AF, Lui WY. Incidence and factors associated with recurrence patterns after intended curative surgery for gastric cancer. World J Surg. 2003 Feb;27(2):153-8. doi: 10.1007/s00268-002-6279-7. PMID: 12616428.
  8. Lai JF, Kim S, Kim K, Li C, Oh SJ, Hyung WJ, Rha SY, Chung HC, Choi SH, Wang LB, Noh SH. Prediction of recurrence of early gastric cancer after curative resection. Ann Surg Oncol. 2009 Jul;16(7):1896-902. doi: 10.1245/s10434-009-0473-x. Epub 2009 May 12. PMID: 19434457.
  9. Kang WZ, Wang BZ, Li DF, Jiang ZC, Xiong JP, Li Y, Jin P, Shao XX, Hu HT, Tian YT. Can Gastric Cancer Patients with High Mandard Score Benefit from Neoadjuvant Chemotherapy? Can J Gastroenterol Hepatol. 2022 Mar 25;2022:8178184. doi: 10.1155/2022/8178184. PMID: 35369117; PMCID: PMC8975703.
  10. Lelisho ME, Seid AA, Pandey D. A Case Study on Modeling the Time to Recurrence of Gastric Cancer Patients. J Gastrointest Cancer. 2022 Mar;53(1):218-228. doi: 10.1007/s12029-021-00684-0. Epub 2021 Aug 11. Erratum in: J Gastrointest Cancer. 2022 Mar;53(1):229. doi: 10.1007/s12029-021-00710-1. PMID: 34379265.
  11. Saito H, Osaki T, Murakami D, Sakamoto T, Kanaji S, Ohro S, Tatebe S, Tsujitani S, Ikeguchi M. Recurrence in early gastric cancer--presence of micrometastasis in lymph node of node negative early gastric cancer patient with recurrence. Hepatogastroenterology. 2007 Mar;54(74):620-4. PMID: 17523336.

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Received July 9, 2025.
Accepted August 16, 2025.
©2025 International Medical Research and Development Corporation.