Kosin Medical Journal

Original articles

Preoperative-pathological staging discordance in gastric cancer: predictive factors and a 10-year institutional series of 2,810 patients: Yoonhong Kim, Seok Hwa Youn, Yeajin Moon, Seung Hun Lee, Kyung Won Seo, Ki Hyun Kim; Kosin Med J. 2026;41(2):145-153. Published online June 16, 2026; DOI: https://doi.org/10.7180/kmj.25.145

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Background
Accurate preoperative staging is crucial for determining treatment strategies in gastric cancer. However, discrepancies between clinical and pathological staging remain common. This study aimed to evaluate the frequency of preoperative staging discordance and to identify associated risk factors.
Methods
We retrospectively analyzed 2,810 patients who underwent curative gastrectomy at a tertiary center between 2012 and 2021. Staging was determined according to the American Joint Committee on Cancer 8th edition criteria. Patients were categorized into concordant, overestimated, or underestimated groups based on discrepancies between clinical and pathological staging. Multivariate logistic regression analysis was performed to identify independent predictors of staging discordance.
Results
The concordance rate between clinical and pathological staging was 81.3%. Overestimation occurred in 8.1% of cases (n=228), whereas underestimation was observed in 10.6% (n=298). Factors independently associated with overstaging included higher hemoglobin levels (odds ratio [OR], 1.14), lower tumor marker levels (carcinoembryonic antigen: OR, 0.97; carbohydrate antigen 19-9: OR, 0.99), and tumors located in the lower third of the stomach (OR, 1.79). Understaging was independently associated with decreased hemoglobin levels (OR, 0.84 per 1 g/dL increase) and involvement of the entire stomach (OR, 8.48).
Conclusions
Staging discordance occurred in approximately 18.7% of patients with gastric cancer. Identification of these key predictors may facilitate more accurate preoperative assessment and support optimization of individualized surgical and therapeutic planning.

Citations

Citations to this article as recorded by

Beyond accuracy: interpreting preoperative staging discordance in gastric cancer
Young Suk Park
Kosin Medical Journal.2026; 41(2): 91. CrossRef

Was there any change in surgical treatment for colorectal cancer during the COVID-19 pandemic?: Yeajin Moon, Seung Hun Lee, Seung Hyun Lee; Kosin Med J. 2025;40(3):207-212. Published online September 23, 2025; DOI: https://doi.org/10.7180/kmj.25.116

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Abstract PDF PubReader ePub: Background
The aim of this study was to review changes in surgical treatment for colorectal cancer during the coronavirus disease 2019 (COVID-19) pandemic at a tertiary hospital in Korea.
Methods
In total, 757 patients who underwent colorectal cancer surgery at Kosin University Gospel Hospital between January 2019 and December 2021 were analyzed. Patients were divided into two groups based on the dates of the COVID-19 pandemic: the pre-pandemic group (321 cases, January 2019 to February 2020) and the pandemic group (436 cases, March 2020 to December 2021). Medical records were reviewed retrospectively to compare surgical treatment patterns.
Results
No significant differences were found in the diagnostic process (asymptomatic vs. symptomatic), preoperative serum carcinoembryonic antigen level (<10 ng/dL vs. ≥10 ng/dL), or cases of obstruction or perforation before and during the COVID-19 pandemic. Combined organ resection was more frequent in the pandemic group (6.2% vs. 13.5%; p=0.06), while stages 0 and 1 cancer were significantly less frequent in the pandemic group (25.8% vs. 18.3%; p=0.008).
Conclusions
During the COVID-19 pandemic, operations for early-stage colorectal cancer (stages 0 and 1) decreased, while combined organ resections increased. These changes in surgical treatment for colorectal cancers are likely to impact oncologic outcomes. Further long-term follow-up studies are necessary to assess the effects of the pandemic on colorectal cancer outcomes.

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