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. 2023 Jan 1;86(1):57-64.
doi: 10.1097/JCMA.0000000000000846. Epub 2022 Nov 14.

The clinicopathological and genetic differences among gastric cancer patients with no recurrence, early recurrence, and late recurrence after curative surgery

Meng-Chao Chen  1   2 , Hsuan-Yu Su  3   4 , Yen-Hao Su  5   6   7   8 , Kuo-Hung Huang  3   4   9 , Wen-Liang Fang  3   4   9 , Chii-Wann Lin  1 , Ming-Huang Chen  4   10 , Yee Chao  4   10 , Su-Shun Lo  4   11 , Anna Fen-Yau Li  4   12 , Chew-Wun Wu  3   4
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The clinicopathological and genetic differences among gastric cancer patients with no recurrence, early recurrence, and late recurrence after curative surgery

Meng-Chao Chen et al. J Chin Med Assoc. .

Abstract

Background: To date, few reports have investigated the genetic alterations and clinicopathological features among gastric cancer (GC) patients with no tumor recurrence, early recurrence, and late recurrence following curative surgery.

Methods: A total of 473 GC patients undergoing curative surgery were included. The clinicopathological characteristics, patient prognosis, recurrence patterns, and genetic alterations were compared between GC patients with early recurrence and late recurrence.

Results: Among the 473 GC patients, 119 had early recurrence (<2 years) and 45 had late recurrence (≥2 years). Patients with early recurrence had tumor size larger than 5 cm, fewer superficial-type tumors, more lymphovascular invasion, more advanced pathological T and N categories and Tumor, Node, Metastasis (TNM) stages, and worse 5-year overall survival than patients with late recurrence and no recurrence. For intestinal-type GC, patients with no tumor recurrence had more Helicobacter pylori infection than patients with early recurrence and late recurrence; for diffuse-type GC patients, the frequency of PIK3CA amplification was the highest in early recurrence, followed by late recurrence and no recurrence. GC patients with single-site recurrence had more ARID1A mutations than those with multiple-site recurrence. Multivariate analysis demonstrated that age, tumor recurrence, and pathological N categories were independent prognostic factors.

Conclusion: PIK3CA amplifications were more common in diffuse-type GC with early recurrence, whereas ARID1A mutations were more common in patients with single-site recurrence. Targeted therapy and immunotherapy might be helpful for these patients.

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Conflict of interest statement

Conflicts of interest: Dr. Yee Chao, an editorial board member at Journal of the Chinese Medical Association, had no role in the peer review process of or decision to publish this article. The other authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.

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