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

  • Yuki Ito
  • Mitsuro KandaEmail author
  • Seiji Ito
  • Yoshinari Mochizuki
  • Hitoshi Teramoto
  • Kiyoshi Ishigure
  • Toshifumi Murai
  • Takahiro Asada
  • Akiharu Ishiyama
  • Hidenobu Matsushita
  • Chie Tanaka
  • Daisuke Kobayashi
  • Michitaka Fujiwara
  • Kenta Murotani
  • Yasuhiro Kodera
Peritoneal Surface Malignancy



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.


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.


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.


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.



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.

Supplementary material

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Yuki Ito
    • 1
    • 2
  • Mitsuro Kanda
    • 2
    Email author
  • Seiji Ito
    • 3
  • Yoshinari Mochizuki
    • 4
  • Hitoshi Teramoto
    • 5
  • Kiyoshi Ishigure
    • 6
  • Toshifumi Murai
    • 7
  • Takahiro Asada
    • 1
  • Akiharu Ishiyama
    • 8
  • Hidenobu Matsushita
    • 9
  • Chie Tanaka
    • 2
  • Daisuke Kobayashi
    • 2
  • Michitaka Fujiwara
    • 2
  • Kenta Murotani
    • 10
  • Yasuhiro Kodera
    • 2
  1. 1.Department of SurgeryGifu Prefectural Tajimi HospitalTajimiJapan
  2. 2.Department of Gastroenterological Surgery (Surgery II)Nagoya University Graduate School of MedicineNagoyaJapan
  3. 3.Department of Gastroenterological SurgeryAichi Cancer Center Chuo HospitalNagoyaJapan
  4. 4.Department of SurgeryKomaki Municipal HospitalKomakiJapan
  5. 5.Department of SurgeryYokkaichi Municipal HospitalYokkaichiJapan
  6. 6.Department of SurgeryKonan Kosei HospitalKonanJapan
  7. 7.Department of SurgeryIchinomiya Municipal HospitalIchinomiyaJapan
  8. 8.Department of SurgeryOkazaki City HospitalOkazakiJapan
  9. 9.Department of SurgeryTosei General HospitalSetoJapan
  10. 10.Division of Biostatistics, Clinical Research CenterAichi Medical University HospitalNagakuteJapan

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