Abstract
BackgroundThe relationship between pathological factors and lymph node metastasis of pathological stage early gastric cancer has been extensively investigated. By contrast, the relationship between preoperative factors and lymph node metastasis of clinical stage early gastric cancer has not been investigated. The present study was to investigate discrepancies between preoperative and postoperative values.MethodsFrom January 2011 to December 2013, 1042 patients with clinical stage early gastric cancer who underwent gastrectomy with lymphadenectomy were enrolled. Preoperative and postoperative values were collected for subsequent analysis. Receiver operating characteristics curves were computed using independent predictive factors.ResultsSeveral discrepancies were observed between preoperative and postoperative values, including existence of ulcer, gross type, and histology (all McNemar p-values were <0.001). Multivariate analyses identified the following independent predictive factors for lymph node metastasis: postoperative values including age (p = 0.002), tumor size (p < 0.001), and tumor depth (p < 0.001); preoperative values including age (p = 0.017), existence of ulcer (p = 0.037), tumor size (p = 0.009), and prediction of the presence of lymph node metastasis in computed tomography scans (p = 0.002). These postoperative and preoperative independent predictive factors produced areas under the receiver operating characteristics curves of 0.824 and 0.660, respectively.ConclusionsSurgeons need to be aware of limitations in preoperative predictions of the presence of lymph node metastasis for clinical stage early gastric cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1940-3) contains supplementary material, which is available to authorized users.
Highlights
The relationship between pathological factors and lymph node metastasis of pathological stage early gastric cancer has been extensively investigated
According to the Japanese guideline, which was established based on Nakagawa et al BMC Cancer (2015) 15:943 numerous pathological data, standard D2 lymphadenectomy is recommended for clinical stage early gastric cancer patients with lymph node metastasis, and more limited lymphadenectomy such as D1 or D1+ can be options for patients with clinical stage early gastric cancer without lymph node metastasis [10]
Preoperative prediction of the presence of lymph node metastasis for clinical stage early gastric cancer patients is challenging, and preoperative diagnosis carries some degree of inaccuracy, so surgeons always need to consider the possibility of overstaging and understaging
Summary
The relationship between pathological factors and lymph node metastasis of pathological stage early gastric cancer has been extensively investigated. The relationship between preoperative factors and lymph node metastasis of clinical stage early gastric cancer has not been investigated. Preoperative prediction of the presence of lymph node metastasis for clinical stage early gastric cancer patients is challenging, and preoperative diagnosis carries some degree of inaccuracy, so surgeons always need to consider the possibility of overstaging and understaging. The relationship between pathological factors and lymph node metastasis of pathological stage early gastric cancer has been extensively investigated, the relationship between preoperative factors and lymph node metastasis of clinical stage early gastric cancer has not been investigated [11,12,13,14,15]. The level of discrepancy between preoperative and postoperative diagnostic values is not well understood
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