Prediction of tumor recurrence after curative resection in gastric carcinoma based on bcl-2 expression

Background: There are currently no reliable predictive factors for gastric cancer recurrence. The aim of this study was to evaluate the relationship between bcl-2 expression and risk of gastric cancer recurrence. Methods: From January 1996 to December 2007, 449 gastric cancer patients who underwent curative resection were retrospectively studied. The expression levels of bcl-2 were examined by immunohistochemistry. Logistic regression was performed to identify independent risk factors for overall recurrence of gastric cancer. Results: 151 patients (33.6%) experienced recurrences. The median time to recurrence was 17.0 months, 113 (74.8%) patients had recurrences within 2 years. Peritoneal recurrence was the most prevalent pattern, followed by hematogenous metastasis in which the liver was the most common site. Depth of invasion, lymph node metastases, and negative expression of bcl-2 were independent risk factors for overall recurrence. The overall survival time of recurrent patients was 22.7 months. The median survival time after recurrence was 6.7 months. Conclusion: The depth of invasion, lymph node metastases and expression of bcl-2 are independent factors for predicting gastric cancer recurrence.