Long term oncological outcome of patients with grossly early gastric cancer-mimicking advanced gastric cancer |
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| Affiliation: | 1. NHS Education for Scotland, 102 West Port, Edinburgh, EH3 9DN, UK;2. Department of Gastrointestinal Surgery, Stavanger University Hospital, POB 8100, N-4068, Stavanger, Norway;3. Department of Clinical Medicine, University of Bergen, Bergen, Norway;4. Department of Surgical Oncology, Medical University of Gdansk, 80-211, Gdańsk, Poland;5. General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, Largo Francesco Vito 1, 00168, Rome, Italy;6. University Hospital Limerick, Ireland;7. Department of General Surgery (Peritoneal Surface Surgical Oncology). University Hospital Principe de Asturias, Alcalá de Henares, Madrid, Spain;8. Department of Surgery, Hospital Clinico San Carlos de Madrid, Instituto de Investigación Sanitaria San Carlos, Universidad Complutense de Madrid, Martín-Lagos, S/N, 28040, Madrid, Spain;1. Department of Medical Oncology, IRCCS Fondazione Istituto Nazionale Tumori, Milan, Italy;2. Department of Pathology, Padua University Hospital, Padua, Italy;3. Unit of Clinical Epidemiology and Trial Organization, IRCCS Fondazione Istituto Nazionale Tumori, Milan, Italy;4. Department of Medical Oncology, Nuovo Ospedale “S.Stefano”, Prato, Italy;5. Department of Orthopaedic Oncology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy;6. Sarcoma Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;7. Department of Surgical Pathology, IRCCS-Rizzoli Orthopaedic Institute, Bologna, Italy;8. Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;9. Department of Pathology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy;10. University of Milan, Department of Oncology and Hemato-oncology, Milan, Italy;1. Department of Colorectal Surgery, Union Hospital, Fujian Medical University, China;2. Department of Radiology, Union Hospital, Fujian Medical University, China;3. Department of Pathology, Union Hospital, Fujian Medical University, China;4. Basic Medical College, Changsha Medical University, China;5. Deepaint Intelligence Technology Co., Ltd., China;1. Nagoya University Graduate School of Medicine, Department of Obstetrics and Gynecology, 65 Tsurumai-cho, Showa-ku, Nagoya-city Aichi, 466-8550, Japan;2. The University of Tokyo, Organization for Interdisciplinary Research Project, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan;3. The University of Tokyo, School of Engineering, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8656, Japan;4. Kaizuka Hospital, Department of Breast Surgery, 7-7-27 Hakozaki Higashi-ku, Fukuoka-city, Fukuoka, 812-0053, Japan;5. Osaka City University Graduate School of Nursing, School of Nursing, 1-5-17 Asahi-machi, Abeno-ku, Osaka-city, Osaka, 545-0051, Japan;6. TOYOTA Memorial Hospital, Department of Obstetrics and Gynecology, 1-1 Heiwa-cho, Toyota-city, Aichi, 471-8513, Japan;7. Hirota Internal Medicine Clinic, 5-19-10 Minamikarasuyama, Setagaya-ku, Tokyo, 157-0062, Japan |
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| Abstract: | BackgroundThe survival of grossly early gastric cancer-mimicking advanced gastric cancer (EGC-mimicking AGC) patients had not been investigated. We evaluated the prognosis of patients who were diagnosed as early gastric cancer before surgery and advanced gastric cancer after surgery.MethodsThis retrospective study reviewed 3592 gastric cancer patients who had radical surgery from January 2007 to February 2015. We used a 1:2 propensity score matching method for the analysis. The matching factors were age, sex, body mass index and the depth of cancer invasion. The 5-year overall survival (OS) and disease-free survival (DFS) of the two study groups were analyzed.ResultsThe 475 grossly EGC-mimicking AGC patients were matched to 910 Borrmann type advanced gastric cancer (AGC) patients. The 5-year OS and DFS of the EGC-mimicking AGC patients were significantly higher than the Borrmann type AGC patients, (89.2% versus 83.4%, p = 0.025; 93.0% versus 85.6%, p < 0.001, respectively). The proportion of patients with lymph node (LN) metastasis was 45.5% in the EGC-mimicking AGC group and 57.1% in the Borrmann type AGC patients (p < 0.001). The ratio of metastatic LNs of N1 and N2 station was 5.2% and 3.1%, respectively, in EGC-mimicking AGC patients; this was lower than in Borrmann type AGC patients (N1: 8.9%, p < 0.001; N2: 3.7%, p = 0.308).ConclusionsPatients with grossly EGC-mimicking AGC had better prognosis than patients with the Borrmann type AGC due to fewer LN metastases. This suggests that limited LN dissection of EGC-mimicking AGC patients may be feasible. |
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| Keywords: | Gastrectomy Grossly early gastric cancer-mimicking advanced gastric cancer Prognosis Lymph node metastasis |
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