ABSTRACT

Improvements in long-term survival of gastric cancer currently reported particularly from specialized centers are attributable primarily to early detection. By stark contrast survival of advanced gastric carcinoma is even now poor. Recurrence at local or distant sites is often accounting for over 80% among cases with both serosal- and nodal-positive cancers, despite complete tumor resection due to an appropriate, standardized extended surgery. Early gastric cancer recurrence occurs in approximately 70% of all recurrent events. We know now that circulating cancer cells are likely responsible for secondary tumor formation but large recent studies failed to show their prognostic significance. Here, we discuss possible explanations for this high rate of early recurrence.