title: Carcinomatous lymphatic invasion in early gastric cancer invading into the submucosa.
abstract: BACKGROUND
  Lymphatic invasion is a risk factor for lymph node metastases in patients with gastric cancer. No studies have been reported, however, on the correlation between lymphatic invasion and lymph node metastasis in early gastric cancer invading into the submucosa.
  
  
  METHODS
  We performed a retrospective analysis of lymphatic invasion in 170 patients with early gastric cancer invading into the submucosa.
  
  
  RESULTS
  Lymphatic invasion was found in 76 patients. Lymphatic invasion correlated significantly with the presence of lymph node metastasis and vascular invasion (P < .05) and with the degree of cancerous submucosal involvement (P < .05). The presence of lymph node metastasis also correlated with the grade of submucosal invasion and lymphatic invasion. The 5-year survival of patients with lymphatic invasion was poorer than that of patients without lymphatic invasion (P < .05). Node-negative patients had similar survival, regardless of the presence of lymphatic invasion. All patients with severe lymphatic invasion had sm3 invasion and lymph node metastases.
  
  
  CONCLUSIONS
  Although lymphatic invasion is the first stage of lymph node metastasis, lymphatic invasion in itself does not have clinical importance except for severe invasion in early gastric cancer. It is possible to predict lymph node metastases from the combined evaluation of degree of lymphatic invasion and submucosal involvement of the tumor in patients with early gastric cancer invading into the submucosa.
authors.affiliation: First Department of Surgery, Kagoshima University School of Medicine, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ishigami
authors.forename: S
authors.initials: S
authors.lastname: Natsugoe
authors.forename: S
authors.initials: S
authors.lastname: Hokita
authors.forename: M
authors.initials: M
authors.lastname: Tokushige
authors.forename: T
authors.initials: T
authors.lastname: Saihara
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: K
authors.initials: K
authors.lastname: Aridome
authors.forename: H
authors.initials: H
authors.lastname: Iwashige
authors.forename: T
authors.initials: T
authors.lastname: Aikou
mesh_terms: D000368:Aged; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate