Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Worse Survival of Patients With T1 Stage II Gastric Cancer Following Radical Gastrectomy

  • Hayemin Lee (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kyo Young Song (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Han Hong Lee (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Junhyun Lee (Department of Surgery, College of Medicine, The Catholic University of Korea)
  • Received : 2023.07.15
  • Accepted : 2023.10.16
  • Published : 2023.10.31
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Abstract

Purpose: Lymph node (LN) metastasis is a crucial factor in the prognosis of patients with gastric cancer (GC) and is known to occur more frequently in cases with an advanced T stage. This study aimed to analyze the survival data of patients with advanced LN metastasis in T1 GC. Materials and Methods: From January 2008 to June 2018, 677 patients with pathological stage II GC who underwent radical gastrectomy were divided into an early GC group (EG: T1N2 and T1N3a, n=103) and an advanced GC (AGC) group (AG: T2N1, T2N2, T3N0, T3N1, and T4aN0, n=574). Short- and long-term survival rates were compared between the 2 groups. Results: A total of 80.6% (n=83) of the patients in the EG group and 52.8% (n=303) in the AG group had stage IIA AGC. The extent of LN dissection, number of retrieved LNs, and short-term morbidity and mortality rates did not differ between the 2 groups. The 5-year relapse-free survival (RFS) of all patients was 87.8% and the overall survival was 84.0%. RFS was lower in the EG group than in the AG group (82.2% vs. 88.7%, P=0.047). This difference was more pronounced among patients with stage IIA (82.4% vs. 92.9%, P=0.003). Conclusions: T1 GC with multiple LN metastases seems to have a worse prognosis compared to tumors with higher T-stages at the same level. Adjuvant chemotherapy is highly recommended for these patients, and future staging systems may require upstaging T1N2-stage tumors.

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References

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