title: Clinical significance of the discrepancy between preoperative and postoperative diagnoses in gastric cancer patients.
abstract: BACKGROUND
  Discrepancies between pre- and postoperative diagnoses can lead to dilemma for operative management adequacy.
  
  
  METHODS
  A total of 2,910 patients with gastric adenocarcinoma underwent curative surgery at the Samsung Medical Center between 2001 and 2003. Patients were divided into four groups: early gastric cancer (EGC)-EGC group that consisted of subjects who were diagnosed as having EGC pre- and postoperatively, advanced gastric cancer (AGC)-EGC group, EGC-AGC group, and AGC-AGC group. Clinicopathologic features and survival rates of groups were analyzed retrospectively.
  
  
  RESULTS
  Of the 2,910 patients, 1,491 (51.2%) patients were included in the EGC-EGC group, 132 (4.5%) in the AGC-EGC group, 120 (4.1%) in the EGC-AGC group, and 1,167 (40.1%) in the AGC-AGC group. The EGC-AGC group showed higher proportions of the followings than the EGC-EGC group: upper-third and middle-third tumor localizations, a tumor size from 2 to 5 cm, undifferentiated adenocarcinoma, Lauren's diffuse type, endolymphatic invasion, vascular invasion, and perineural invasion. Five-year survival rates were dependent on the final pathologic stages, not on the preoperative stages. Multivariate analysis revealed that age and American Joint Committee of Cancer stage were independent prognostic factors of patient survival.
  
  
  CONCLUSIONS
  A decision regarding minimally invasive treatment for EGC must be made having considered tumor location, size, and cellular differentiation, because of the possibility of an incorrect preoperative diagnosis.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Suk Hee
authors.initials: SH
authors.lastname: Shin
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Bae
authors.forename: Hun
authors.initials: H
authors.lastname: Jung
authors.forename: Min Gew
authors.initials: MG
authors.lastname: Choi
authors.forename: Jun Haeng
authors.initials: JH
authors.lastname: Lee
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Noh
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Sohn
authors.forename: Sung
authors.initials: S
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed