Hazard rates of recurrence for gastric cancer after curative resection: implications for postoperative surveillance

Identifying the most effective postoperative surveillance interval in patients with gastric cancer (GC) remains challenging. To elucidate a logical and effective surveillance schedule, we analyzed GC recurrence risk trends after gastrectomy using the hazard function.

We retrospectively reviewed the medical records of 2503 patients who underwent curative GC resection between 2000 and 2018. We examined recurrence risk over time and the influence of clinicopathological variables on it.

Overall, GC recurred in 291 patients (11.6%) over a median of 64.6 months. Recurrence risk was highest at approximately 11-months postoperatively (hazard rate [HR]: 0.0045), decreasing to half the peak at approximately 39-months postoperatively. Patients with Stage I GC maintained a low risk. In Stage II patients, the risk peaked at 16-months postoperatively (HR: 0.006) and gradually declined thereafter. Stage III patients had the highest risk at 11 months postoperatively (HR: 0.019), plateauing at 40 months.

We demonstrated significant cancer stage-dependent differences in postsurgical GC recurrence risk by using the hazard function. Reductions in surveillance intensity might be acceptable according to the individual risk of recurrence.