Clinical and Morphological Indicators of Early Gastric Cancer Recurrence

Background: Despite advancements in diagnostics and the widespread adoption of multimodal therapy for gastric cancer, early recurrence continues to pose a serious clinical challenge. This study aims to identify clinical, morphological, and perioperative factors associated with early recurrence (≤6 months) of gastric cancer after completion of combined treatment and to develop a prognostic model for assessing the risk of recurrence. Methods and Results: This retrospective study included data from 199 patients who underwent gastrectomy with D2 lymph node dissection in a regional oncology center. A total of 88 patients who completed combined (multimodal) treatment were included in the final statistical analysis. Clinical and tumor-related characteristics, response to treatment, and surgical parameters were evaluated. Patients were divided into two groups based on the presence or absence of recurrence within 6 months. Logistic regression analysis was used to identify independent predictors. Model performance was assessed using ROC analysis. Among the 88 patients included in the final analysis, disease recurrence was observed in 44 cases (50%). Of these, 21 patients (47.7%) experienced a recurrence within the first six months following completion of combined treatment. The multivariate analysis confirmed that poor tumor differentiation (G3) (OR = 6,084; 95% CI: 1,124–32,917) and the presence of lymphovascular invasion (OR = 9,902; 95% CI: 2,061–47,560) play a significant role in the likelihood of gastric cancer recurrence following the completion of combined treatment. The prognostic model demonstrated good discriminatory ability, with an AUC of 0.852 (95% CI: 0.735–0.969), sensitivity of 85.7%, and specificity of 73.9%. Conclusion: Lymphovascular invasion and poor tumor differentiation may serve as independent risk factors for recurrence within the first six months following completion of combined treatment for gastric cancer. The developed model may be helpful in stratifying risk and personalizing postoperative surveillance.