Objective:To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods:We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014.Patients stratified according to lymph node status and recurrence patterns among different subgroups were compared.Results:Of all,517(30.5％ )patients developed recurrent disease,and complete data of recurrence could be obtained in 493(95.4％ )patients.For pN0 patients,the patterns of recurrence were different according to pT stage:locoregional recurrence was most common in patients with pT1-2 disease(57.1％ ),distant recurrence was most common in patients with pT3 disease(57.1％ ),and peritoneal recurrence was most common in patients with pT4a disease(66.7％ ).For pN+patients,distant metastasis was most common pattern irrespective of pT stage.The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with pN0-2 disease but plateaued 3 years after surgery in patients with pN3 disease.Time to recurrence was significantly longer for the pN0 patients compared with the pN+patients(median:25 vs.16 months,P=0.001).Moreover,post-recurrence survival was significantly better for the pN0 patients than for the pN+patients(median:12 vs.6 months,P＜0.001),especially in patients with non-peritoneal recurrence,late recurrence,single recurrence,and receipt of potential curative treatment.Conclusions:Among clinicopathologic factors,lymph node status is the most important factor associated with recurrence patterns after curative gastrectomy.Lymph node status may be used as an adjunct in clinical decision-making about postoperative therapeutic and follow-up strategies.