title: Clinicopathologic characteristics and prognosis of advanced gastric cancer simulating early gastric cancer.
abstract: BACKGROUND
  Although the clinicopathologic features and prognosis of Borrmann type advanced gastric cancer has been well characterized, those of advanced gastric cancer simulating early gastric cancer (AGC simulating EGC) still remains unclear.
  
  
  METHODS
  We reviewed 1985 gastric cancer patients who had undergone gastrectomy at our hospital to determine the clinicopathologic characteristics, susceptible sites for lymph node metastasis, and prognosis of AGC simulating EGC in comparison with Borrmann type advanced gastric cancer.
  
  
  RESULTS
  Among 102 patients with AGC simulating EGC, 100 patients (98%) had tumors with depressed type appearance. The frequencies of serosal invasion, lymph node metastasis, lymphatic vessel invasion, blood vessel invasion, and liver metastasis were significantly lower in AGC simulating EGC than in Borrmann type tumors. The prognosis of AGC simulating EGC was significantly better than that of the Borrmann type tumors. Multivariate analysis indicated that the gross appearance was an independent prognostic factor. In patients with AGC simulating EGC which invaded to the the muscularis propria (MP), most lymph node metastasis was restricted with the perigastric lymph nodes (1st-titer lymph nodes) and lymph node metastasis to 2nd-titer lymph nodes was only observed at station 8a.
  
  
  CONCLUSIONS
  AGC simulating EGC is less advanced in comparison with Borrmann type advanced gastric cancer. Based on the results of susceptible sites for lymph node metastasis in the current study, limited lymph node dissection could be indicated for AGC simulating EGC whose depth of invasion is MP.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Saito
authors.forename: Kozo
authors.initials: K
authors.lastname: Miyatani
authors.forename: Seigo
authors.initials: S
authors.lastname: Takaya
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Matsunaga
authors.forename: Yoji
authors.initials: Y
authors.lastname: Fukumoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osaki
authors.forename: Toshiro
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: Masahide
authors.initials: M
authors.lastname: Ikeguchi
keywords: gastric cancer; gross appearance; lymph node dissection; prognosis