Impact of lymphovascular invasion in patients with stage I gastric cancer

• Published in: Surgery 2010-02, Vol.147 (2), p.204-211
• Main Authors: Kunisaki, Chikara, MD, PhD, Makino, Hirochika, MD, PhD, Kimura, Jun, MD, Takagawa, Ryo, MD, Kosaka, Takashi, MD, Ono, Hidetaka A., MD, PhD, Akiyama, Hirotoshi, MD, PhD, Fukushima, Tadao, MD, PhD, Nagahori, Yutaka, MD, PhD, Takahashi, Masazumiu, MD, PhD
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Female; Gastrectomy; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Lymph Node Excision; Lymphatic Metastasis; Lymphatic Vessels - pathology; Male; Medical sciences; Middle Aged; Neoplasm Invasiveness; Prognosis; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Survival Rate; Tumors; Young Adult
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2009.08.012

Background Patients with stage I gastric cancer often suffer from tumor recurrence despite a generally favorable operative outcome. It is therefore important to determine the prognostic factors in order to improve such outcomes. Methods Between April 1985 and March 2000, a total of 1,880 patients with histologically proven stage I gastric cancer were included in this study. Operative outcomes (survival time, prognostic factors, pattern of recurrence) were evaluated in these patients. Results Multivariate analysis in patients with all stage I gastric cancer revealed that depth of invasion, lymph node metastasis, and lymphovascular invasion independently influenced prognosis. Moreover, advanced age was selected as an independent prognostic factor in patients with stage IA, and lymphovascular invasion in patients with stage IB gastric cancer by multivariate analyses. The 5-year survival rates in stage T1N1 patients with moderate to severe lymphovascular invasion, T2N0 with moderate to severe lymphovascular invasion, and II were 95.1%, 83.5%, and 76.9%, respectively. There was a significant difference in survival time between stage T1N1 and II ( P = .0189) but not between stage T1N1 and T2N0 or stage T2N0 and II. Conclusion T2N0 gastric cancer patients with moderate to severe lymphovascular invasion may be suitable candidates for adjuvant chemotherapy.