Skip to main content
SpringerLink
Log in

Prognosis After Laparoscopic Gastrectomy in Patients with Pathological Stage II or III Gastric Cancer Who Were Preoperatively Diagnosed with Clinical Stage I: Propensity Score Matching Analysis of a Multicenter Dataset

  • Peritoneal Surface Malignancy
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Laparoscopic gastrectomy (LG) is a standard approach for patients with clinical stage I gastric cancer in East Asia; however, following surgery, these patients may be pathologically diagnosed with stage II or III cancer. The prognosis of patients with gastric cancer migration from clinical stage I to pathological stage II or III after LG has not been completely clarified.

Methods

To compare the prognosis following LG and open gastrectomy (OG) in patients with pathological stage II or III gastric cancer who were preoperatively diagnosed with stage I cancer, we conducted a retrospective analysis using a multicenter dataset comprising details of 3480 patients who underwent gastrectomy between 2010 and 2014 at nine participating institutions. We used propensity score matching to reduce selection bias.

Results

After propensity score matching, 146 patients were finally selected. There were no significant differences in the number of dissected lymph nodes. Morbidity rates, length of postoperative hospital stay, and time between surgery and initiation of adjuvant chemotherapy were comparable between the two groups. Moreover, there were no significant differences in the overall, disease-specific, and relapse-free survival rates between the LG and OG groups. The LG group tended to have more patients with hematogenous recurrence, whereas the OG group tended to have more patients with peritoneal recurrence.

Conclusions

Our multicenter dataset analysis indicated that the prognosis of patients with gastric cancer migration from clinical stage I to pathological stage II or III was independent of the surgical approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Katai H, Ishikawa T, Akazawa K, Isobe Y, Miyashiro I, Oda I, et al., Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001–2007). Gastric Cancer. 2018;21:144–54.

    Article  Google Scholar 

  2. Kanda M, Fujiwara M, Tanaka C, Kobayashi D, Iwata N, Mizuno A, et al. Predictive value of drain amylase content for peripancreatic inflammatory fluid collections after laparoscopic (assisted) distal gastrectomy. Surg Endosc. 2016;30:4353–62.

    Article  Google Scholar 

  3. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20:1–19.

    Article  Google Scholar 

  4. Fukagawa T, Katai H, Mizusawa J, Nakamura K, Sano T, Terashima M, et al. A prospective multi-institutional validity study to evaluate the accuracy of clinical diagnosis of pathological stage III gastric cancer (JCOG1302A). Gastric Cancer. 2018;21:68–73.

    Article  Google Scholar 

  5. Wu CW, Hsiung CA, Lo SS, Hsieh MC, Chen JH, Li AF, et al., Stage migration influences on stage-specific survival comparison between D1 and D3 gastric cancer surgeries. Eur J Surg Oncol. 2005;31:153–7.

    Article  CAS  Google Scholar 

  6. Kinoshita T, Uyama I, Terashima M, Noshiro H, Nagai E, Obama K, et al., Long-term outcomes of laparoscopic versus open surgery for clinical Stage II/III gastric cancer: a multicenter cohort study in Japan (LOC-a study). Ann Surg. 2019;269(5):887–94.

    Article  Google Scholar 

  7. Martinez-Ramos D, Miralles-Tena JM, Cuesta MA, Escrig-Sos J, Van der Peet D, Hoashi JS, et al., Laparoscopy versus open surgery for advanced and resectable gastric cancer: a meta-analysis. Rev Esp Enferm Dig. 2011;103:133–41.

    Article  CAS  Google Scholar 

  8. Chen K, Xu XW, Mou YP, Pan Y, Zhou YC, Zhang RC, et al., Systematic review and meta-analysis of laparoscopic and open gastrectomy for advanced gastric cancer. World J Surg Oncol. 2013;11:182.

    Article  Google Scholar 

  9. Inaki N, Etoh T, Ohyama T, Uchiyama K, Katada N, Koeda K, et al., A multi-institutional, prospective, Phase II feasibility study of laparoscopy-assisted distal gastrectomy with D2 Lymph node dissection for locally advanced gastric cancer (JLSSG0901). World J Surg. 2015;39:2734-41.

    Article  Google Scholar 

  10. Hayashi S, Kanda M, Ito S, Mochizuki Y, Teramoto H, Ishigure K, et al., Number of retrieved lymph nodes is an independent prognostic factor after total gastrectomy for patients with stage III gastric cancer: propensity score matching analysis of a multi-institution dataset. Gastric Cancer. 2019;22(4):853–63.

    Article  Google Scholar 

  11. Ryo S, Kanda M, Ito S, Mochizuki Y, Teramoto H, Ishigure K, et al. The controlling nutritional status score serves as a predictor of short- and long-term outcomes for patients with Stage 2 or 3 gastric cancer: analysis of a multi-institutional data set. Ann Surg Oncol. 2019;26(2):456–64.

    Article  Google Scholar 

  12. Ito Y, Kanda M, Ito S, Mochizuki Y, Teramoto H, Ishigure K, et al., Intraoperative Blood Loss is Associated with Shortened Postoperative Survival of Patients with Stage II/III Gastric Cancer: Analysis of a Multi-institutional Dataset. World J Surg. 2019;43:870–7.

    Article  Google Scholar 

  13. Liu JY, Peng CW, Yang XJ, Huang CQ, Li Y. The prognosis role of AJCC/UICC 8(th) edition staging system in gastric cancer, a retrospective analysis. Am J Transl Res. 2018;10:292–303.

    PubMed  PubMed Central  Google Scholar 

  14. Kanda M, Kodera Y, Sakamoto J. Updated evidence on adjuvant treatments for gastric cancer. Expert Rev Gastroenterol Hepatol. 2015;9:1549–60.

    Article  Google Scholar 

  15. Kanda M, Murotani K, Kobayashi D, Tanaka C, Yamada S, Fujii T, et al. Postoperative adjuvant chemotherapy with S-1 alters recurrence patterns and prognostic factors among patients with stage II/III gastric cancer: a propensity score matching analysis. Surgery. 2015;158:1573–80.

    Article  Google Scholar 

  16. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187-96.

    Article  Google Scholar 

  17. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48:452–8.

    Article  CAS  Google Scholar 

  18. Katai H, Mizusawa J, Katayama H, Takagi M, Yoshikawa T, Fukagawa T, et al. Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA/IB gastric cancer: japan clinical oncology group study JCOG0912. Gastric Cancer. 2017;20:699–708.

    Article  Google Scholar 

  19. Kim HH, Han SU, Kim MC, Kim W, Lee HJ, Ryu SW, et al. Effect of laparoscopic distal gastrectomy vs open distal gastrectomy on long-term survival among patients with Stage I gastric cancer: the KLASS-01 randomized clinical trial. JAMA Oncol. 2019;5(4):506–13.

    Article  Google Scholar 

  20. Hikage M, Tokunaga M, Makuuchi R, Irino T, Tanizawa Y, Bando E, et al. Surgical outcomes after gastrectomy in very elderly patients with gastric cancer. Surg Today. 2018;48(8):773–82.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan

    Yuki Ito MD & Takahiro Asada MD

  2. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yuki Ito MD, Mitsuro Kanda MD, FACS, Chie Tanaka MD, Daisuke Kobayashi MD, Michitaka Fujiwara MD & Yasuhiro Kodera MD, FACS

  3. Department of Gastroenterological Surgery, Aichi Cancer Center Chuo Hospital, Nagoya, Japan

    Seiji Ito MD

  4. Department of Surgery, Komaki Municipal Hospital, Komaki, Japan

    Yoshinari Mochizuki MD

  5. Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan

    Hitoshi Teramoto MD

  6. Department of Surgery, Konan Kosei Hospital, Konan, Japan

    Kiyoshi Ishigure MD

  7. Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan

    Toshifumi Murai MD

  8. Department of Surgery, Okazaki City Hospital, Okazaki, Japan

    Akiharu Ishiyama MD

  9. Department of Surgery, Tosei General Hospital, Seto, Japan

    Hidenobu Matsushita MD

  10. Division of Biostatistics, Clinical Research Center, Aichi Medical University Hospital, Nagakute, Japan

    Kenta Murotani PhD

Authors
  1. Yuki Ito MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mitsuro Kanda MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seiji Ito MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoshinari Mochizuki MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hitoshi Teramoto MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kiyoshi Ishigure MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Toshifumi Murai MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takahiro Asada MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Akiharu Ishiyama MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hidenobu Matsushita MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Chie Tanaka MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Daisuke Kobayashi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Michitaka Fujiwara MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Kenta Murotani PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Yasuhiro Kodera MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mitsuro Kanda MD, FACS.

Ethics declarations

DISCLOSURE

Yuki Ito, Mitsuro Kanda, Seiji Ito, Yoshinari Mochizuki, Hitoshi Teramoto, Kiyoshi Ishigure, Toshifumi Murai, Takahiro Asada, Akiharu Ishiyama, Hidenobu Matsushita, Chie Tanaka, Daisuke Kobayashi, Michitaka Fujiwara, Kenta Murotani, and Yasuhiro Kodera declare they have no conflicts of interest and no sources of financial support were used in the preparation of this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 58 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ito, Y., Kanda, M., Ito, S. et al. Prognosis After Laparoscopic Gastrectomy in Patients with Pathological Stage II or III Gastric Cancer Who Were Preoperatively Diagnosed with Clinical Stage I: Propensity Score Matching Analysis of a Multicenter Dataset. Ann Surg Oncol 27, 268–275 (2020). https://doi.org/10.1245/s10434-019-07781-2

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-019-07781-2

Search

Navigation