Molecular profiling of gastric cancer tumors can improve risk stratification for recurrence post-surgery.

• In a study of 438 patients, 179 experienced recurrence after resection.
• Alterations in the KRAS gene (HR 1.54) and PIK3CA (HR 2.15) were linked to poorer disease-free survival.
• Patients with hematogenous recurrence had significant chromosomal instability, suggesting personalized surveillance may be beneficial.
• Genomic stability was associated with bone metastases, indicating histological types may guide treatment strategies.