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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2019

01-06-2019 | Metastasis | Gastrointestinal Oncology

The Relevance of Serosal Exposure Without Nodal Metastasis in Resectional Gastric Cancer

Authors: Yoon Ju Jung, MD, Ho Seok Seo, MD, Ji Hyun Kim, MD, Cho Hyun Park, MD, Han Hong Lee, MD

Published in: Annals of Surgical Oncology | Issue 6/2019

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Abstract

Background

According to 8th AJCC/UICC TNM criteria, stage IIB includes pT1N3M0, pT2N2M0, pT3N1M0, and pT4aN0M0, which includes not only early gastric cancer but also locally advanced cancer. There are currently no data about whether there is any additional impact of serosal exposed cancer without nodal metastasis (pT4aN0) on patients’ survival outcomes compared with other subgroups in IIB.

Methods

Patients who underwent radical gastrectomy for gastric cancer patients were enrolled, including 427 patients in stage IIB; 20 (4.68%), 104 (24.35%), 172 (40.28%), and 131 (30.67%) patients were classified as pT1N3a, pT2N2, pT3N1, and pT4aN0, respectively. Clinicopathological characteristics, recurrence pattern, and survival and recurrence rates were analyzed according to the TNM subgroups.

Results

Cancer-specific and relapse-free survival were significantly worse in serosal exposed cancer than in nonserosal exposed cancer in stage IIB (P = 0.019 and P = 0.015). Recurrence rate was highest in the pT4aN0 subgroup (29.0%) in stage IIB, and peritoneal metastasis was the most common pattern. Survival outcomes of the pT4aN0 subgroup were not significantly different from those of the stage IIIA or pT4aN1 subgroups.

Conclusions

Patients with serosal exposed cancer without nodal metastasis shows worse cancer specific and disease-free survival with higher incidence of peritoneal metastasis than other subgroups in stage IIB. Further surveillance studies, including staging laparoscopy and active adjuvant therapy, are required in this subgroup of patients.
Appendix
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Metadata
Title
The Relevance of Serosal Exposure Without Nodal Metastasis in Resectional Gastric Cancer
Authors
Yoon Ju Jung, MD
Ho Seok Seo, MD
Ji Hyun Kim, MD
Cho Hyun Park, MD
Han Hong Lee, MD
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07221-1

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