Is surgery alone sufficient for treating T1 gastric cancer with extensive lymph node metastases?
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ORIGINAL ARTICLE
Is surgery alone sufficient for treating T1 gastric cancer with extensive lymph node metastases? Masahiro Yura1 · Takaki Yoshikawa1 · Sho Otsuki1 · Yukinori Yamagata1 · Shinji Morita1 · Hitoshi Katai1 · Toshirou Nishida1 Received: 9 May 2019 / Accepted: 2 September 2019 © The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2019
Abstract Background Whether or not surgery alone is sufficient for treating patients with pathological stage T1N2M0 (Stage IIA), T1N3a/bM0 (Stage IIB/IIIB), and T3N0M0 (Stage IIA) gastric cancer who were not indicated for adjuvant treatment according to the Japanese gastric cancer treatment guideline remains unclear. Methods We retrospectively reviewed the clinical records of 236 patients who had been diagnosed with pT1N2-3b/pT3N0 gastric cancer and undergone R0 gastrectomy with lymph node dissection between January 2000 and December 2012 at the National Cancer Center Hospital, Japan. Results The 5-year recurrence-free survival (RFS) rates (95% confidence interval [CI]) of the patients with pathological (p) T1N2-3b and T3N0 cancer were 73.9% (63.1–84.7) and 89.5% (84.0–95.0), respectively. The only significant prognostic factors for the survival identified by a multivariate Cox regression analysis in patients with pT1N2-3 cancer were the pN stage (N3a/N2: hazard ratio [HR] 2.940, 95% CI 1.314–5.577; N3b/N2: HR 8.688, 95% CI 3.096–24.382) and tumor diameter (
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