Genomic Profiling of Primary Gastric Tumors Predicts Recurrence Patterns and Survival Outcomes

Highlight

• Alterations in KRAS and PIK3CA genes independently associate with worse disease-free survival in resected gastric cancer.
• Distinct genomic characteristics differentiate patterns of recurrence: hematogenous, peritoneal, and lymphatic metastases.
• Hematogenous recurrence correlates with increased chromosomal instability and cell cycle regulatory gene alterations.
• Bony metastases arise predominantly from genomically stable, diffuse-type tumors, highlighting histologic-genomic interplay.

Study Background