Risk factors for recurrence in patients with pT3N0 gastric cancer after curative resection

Background Patients with the pT3N0 gastric cancer (GC) have higher post-operative recurrence compared to that in individuals with other p-stage II GCs. The indications for adjuvant chemotherapy for patients with pT3N0 GC have not been established yet. We aimed to identify risk factors for recurrence in patients with pT3N0 GC following curative resection and discover the subgroup of patients that may benefit from adjuvant chemotherapy. Materials and Methods. Consecutive patients with pT3N0 GC undergoing curative resection at a tertiary medical center from January 2006 to April 2024 were retrospectively reviewed, and the clinicopathological factors and oncological outcomes were analyzed. Results. In total, 143 patients with pT3N0 GC were included, of which 26 (18.2%) had post-operative recurrence. Male sex ( p = 0.013), higher carcinoembryonic antigen level ( p = 0.006), and tumor size larger than 3 cm ( p = 0.019) were found to be significantly associated with shorter recurrence free survival (RFS). In the multivariate analysis, tumor size larger than 3 cm was found to be an independent factor for recurrence (hazard ratio, 4.8; 95% confidence interval, 1.1–20.7). The 5-year RFS was significantly longer in patients with tumor size larger than 3 cm when stratified by the use of adjuvant chemotherapy (82.1% vs. 67.8%, p = 0.021). Conclusions. Large tumor size is the only significant risk factor for recurrence in patients with pT3N0 GC after curative surgery in the multivariate analysis. Adjuvant chemotherapy may improve the survival outcome for these patients.