• Meng-Chao Chen, Hsuan-Yu Su, Yen-Hao Su, Kuo-Hung Huang, Wen-Liang Fang, Chii-Wann Lin, Ming-Huang Chen, Yee Chao, Su-Shun Lo, Fen-Yau LiAnnaASchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC., and Chew-Wun Wu.
• Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ROC.
• J Chin Med Assoc. 2023 Jan 1; 86 (1): 576457-64.

BackgroundTo 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.MethodsA 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.ResultsAmong 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.ConclusionPIK3CA 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.Copyright © 2022, the Chinese Medical Association.

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