Ito Y, Kanda M, Ito S, et al. - Patients with pathological stage II or III gastric cancer who were preoperatively diagnosed with stage I cancer and underwent laparoscopic gastrectomy (LG) or open gastrectomy (OG) were compared regarding the prognosis. A multicenter dataset comprising details of 3,480 patients who underwent gastrectomy at nine participating institutions between 2010 and 2014 were retrospectively analyzed and of these, 146 patients were finally selected following propensity score matching for this work. The LG and OG groups showed comparable morbidity rates, length of postoperative hospital stay, and time between surgery and initiation of adjuvant chemotherapy and showed no significant differences in the overall, disease-specific, and relapse-free survival rates. More patients with hematogenous recurrence were evident in the LG group, whereas more patients with peritoneal recurrence were observed in the OG group. These findings suggest no influence of the surgical approach on the prognosis of patients with gastric cancer migration from clinical stage I to pathological stage II or III.