Objective: Early gastric cancers have recently become more prevalent, and therefore, characterization of the features of patients who develop recurrence and second cancers is necessary for the development of effective postoperative follow-up strategies. Methods: We evaluated the clinicopathological features and the timing of the development of both recurrence and second primary cancer after surgery for early gastric cancer in 671 patients. Results: The incidence rate of recurrent early gastric cancer was 2.1%, and the incidence rate of second primary cancer was 4.8%, with an associated death rate of 3.3%. Most multiple primary cancers cases involved the colorectum and the lung. A multivariate analysis of overall survival identified multiple primary cancers, age, and sex as prognostic factors for early gastric cancer. The average interval from surgery to diagnosis of recurrence was identified as 3.4 ± 2.1 years. The average interval for peritoneal recurrence was shorter than that for hematogenous recurrence (P < 0.05). The average interval from diagnosis of early gastric cancer to diagnosis of the second primary cancer was 7.1 ± 4.6 years. Conclusion: Patients with early gastric cancer, particularly patients who are males, elderly and have lymphatic involvement, tend to have a greater risk of developing a second primary cancer and recurrence, respectively.
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