Abstract
Limited gastrectomy has been generally performed in clinical T1N0 gastric cancer. The aim of this study was to identify risk factors for stage underestimation in clinical T1N0 gastric cancer. This study reviewed the medical records of 566 patients who underwent gastrectomy for clinical T1N0 gastric cancer. The tumor stage was underestimated in 122 (21.6%) patients. The relapse-free survival rate was significantly lower in the patients with pathological stage II (P = 0.021) and III (P < 0.001) disease than in those with pathological stage IA disease. In the multivariate analysis, a location in the upper third of the stomach, tumor size of ≥ 30mm, undifferentiated adenocarcinoma and clinical tumor depth of SM were identified as independent risk factors for pathological stages II and III. The rate of pathological stages II and III was 0% in the patients with no risk factors, 3% in those with 1 risk factor, 10.5% in those with 2 risk factors, 19.8% in those with 3 risk factors and 50% in those with 4 risk factors. Location, tumor size, undifferentiated adenocarcinoma and clinical tumor depth were independent risk factors for pathological stages II and III in clinical T1N0 gastric cancer.
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