T2 or greater disease but were diagnosed preoperatively with early gastric cancer.

BACKGROUND/AIMS: This study was conducted to explore the characteristics of the patients who were diagnosed preoperatively with early gastric cancer but pathologically confirmed T2 or greater disease. METHODOLOGY: Seventy-two patients, who were diagnosed preoperatively with early gastric cancer between August 2001 and December 2006, but had T2a or more lesions by pathological examination, were included in this study. The potential clinical and pathological factors and lymph node metastasis based on the recommendations of the Japanese Research Society for Gastric Carcinoma (JRSGC) were analyzed. RESULTS: Among the 705 patients identified, there were 90 (12.8%) with proven T2 or more advanced gastric cancer at pathological examination. Thirty-eight out of 72 (47.2%) patients had metastatic lymph nodes. Fourteen patients (19.4%) had metastatic lymph nodes at the topographical N2 lymph node station on pathological examination. Logistic regression analysis revealed that lymphovascular invasion was an independent risk factor for topographical N2 lymph node metastasis (Coefficient; -2.144, standard error; 0.95, relative risk; 0.117, 95% of confidence interval of relative risk; 0.028-0.498, p=0.004). CONCLUSIONS: The current study suggests that laparoscopic surgeons should pay attention to the selection of patients and the patients confirmed to have T2 or more gastric cancers with lymphovascular invasion on pathological examination after laparoscopy-assisted gastrectomy need close follow-up.