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Worse Survival of Patients With T1 Stage II Gastric Cancer Following Radical Gastrectomy.

Authors
  • Lee, Hayemin1
  • Song, Kyo Young1
  • Lee, Han Hong1
  • Lee, Junhyun2
  • 1 Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. , (North Korea)
  • 2 Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. [email protected]. , (North Korea)
Type
Published Article
Journal
Journal of gastric cancer
Publication Date
Oct 01, 2023
Volume
23
Issue
4
Pages
598–608
Identifiers
DOI: 10.5230/jgc.2023.23.e40
PMID: 37932226
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. 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). 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. Copyright © 2023. Korean Gastric Cancer Association.

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