134P - Effect of preoperative tumour under-staging on the long-term survival of patients undergoing radical gastrectomy for gastric cancer

Background

This study aimed to evaluate the effect of preoperative tumour staging deviation (PTSD) on the long-term survival of patients undergoing radical gastrectomy for gastric cancer (RGGC).

Methods

Clinicopathological data of 2 346 patients who underwent RGGC were retrospectively analysed. The preoperative tumour-lymph node-metastasis (TNM) under-staging group (uTNM) comprised patients who had earlier preoperative TNM than postoperative TNM, and the no preoperative under-staging group (nTNM) comprised the remaining patients.

Results

There were 1 031 uTNM (44.0%) and 1 315 nTNM cases (56.0%). Cox prognostic analysis revealed that PTSD independently affected the overall survival (OS) after surgery. The 5-year OS was lower in the uTNM group (41.8%) than in the nTNM group (71.6%). Analysis of surgical and pathological factors showed that among patients with pT2, pT3+4, and pN+, all patients in group nTNM underwent D2 lymph node dissection (LND), whereas 15.1%, 1.3%, and 5.5% patients in group uTNM underwent D1 + LND, respectively. Among patients with pN0, the lymph node noncompliance rate was higher in the uTNM than in the nTNM group. Logistic analyses revealed that high BMI, tumour size <2 cm, early gross typing, and differentiated tumours in the upper stomach independently affected uTNM (P < 0.05).

Conclusions

Underestimated tumour staging is not rare, which possibly results in inadequate LND and affects the long-term survival for patients undergoing RGGC. D2 LND should be carefully performed in patients who are predisposed to this underestimation.

Clinical trial identification

Legal entity responsible for the study

The authors.

Funding

Scientific and Technological Innovation Joint Capital Projects of Fujian Province.

Disclosure

All authors have declared no conflicts of interest.