Prognostic impact of lymphatic and/or blood vessel invasion in patients with node-negative advanced gastric cancer.
BACKGROUND
Heterogeneous survival rates in patients with similar clinicopathologic characteristics or molecular prognostic markers have been noted. This study was conducted to evaluate the prognostic effect of lymphatic and/or blood vessel invasion (LBVI), identified by routine hematoxylin and eosin staining, on the outcome of patients with node-negative advanced gastric cancer.


METHODS
A total of 280 patients who underwent curative gastrectomy for advanced gastric cancer without lymph node metastasis were retrospectively reviewed. Univariate and multivariate analyses of the clinicopathological features, recurrences, and prognoses of patients with and without LBVI were performed.


RESULTS
Lymphatic vessel invasion (LVI) was noted in 20.0%, blood vessel invasion (BVI) in 5.4%, and either LVI or BVI in 22.5%. None of the clinicopathologic features was related to LBVI. Patients with LBVI had a recurrence rate of 26.8%, whereas patients without LBVI had a recurrence rate of 13.5% (P =.018). The 5-year survival rates were 82.4% for patients without LBVI and 67.1% for patients with LBVI (P =.0222). LBVI was shown to be an independent risk factor for recurrence (relative risk, 2.30; 95% confidence interval, 1.06-4.99) and poor prognosis (relative risk, 1.88; 95% confidence interval, 1.07-3.29).


CONCLUSIONS
LBVI is an adverse prognostic indicator and the presence of LBVI seems to provide useful information for the prognosis and clinical management of patients with node-negative advanced gastric carcinoma.
Hyung
Woo Jin
WJ
Department of Surgery, the Cancer Metastasis Research Center, Yonsei University College of Medicine, Seoul, Korea.
Lee
Jun Ho
JH
Choi
Seung Ho
SH
Min
Jin Sik
JS
Noh
Sung Hoon
SH
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology*; D000704:Analysis of Variance; D001808:Blood Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate