title: Clinicopathological characteristics and prognosis of early gastric cancer after gastrectomy.
abstract: BACKGROUND
  Assessment of lymph node metastasis (LNM) is important in early gastric cancer (EGC) and affects treatment decisions. However, the relationship between clinicopathological characteristics and LNM in EGC remains unclear. This study therefore explored favorable predictors of LNM in EGC.
  
  
  METHODS
  A total of 716 specimens from gastric cancer patients who underwent curative gastrectomy between 1996 and 2003 at Zhejiang Provincial People's Hospital were reviewed. Forty-five cases were EGC, and clinicopathological characteristics such as gender, age, tumor size, location, gross type, differentiation, invasion depth, and vessel involvement were assessed to identify predictive factors for LNM and survival time.
  
  
  RESULTS
  The overall cumulative 5-year survival rate of EGC patients was 88.92%. Among these, 22.4% developed LNM, which was associated with a poor 5-year survival rate of only 72.7%. Patients with tumors larger than 2 cm in diameters, with depth of tumor invasion to the submucosa, and with positive lymphatic or nerve involvement were also inclined to have poorer survival performances. EGC limited to the mucosa but poorly differentiated also had a high risk for LNM. Multivariate analysis identified lymphatic invasion and tumor size as independent prognosis factors related to survival in EGC patients.
  
  
  CONCLUSIONS
  Careful planning is required in EGC patients at high risk of lymph node metastases. Endoscopic mucosal resection or endoscopic submucosal dissection and laparoscopic partial gastrectomy should be cautiously used in EGC, and curative gastrectomy including lymphatic dissection and postoperative adjuvant therapy might be considered to improve the prognosis.
authors.affiliation: Department of General Surgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang 310014, China. yxwang910@yahoo.com.cn
authors.forename: Yong-xiang
authors.initials: YX
authors.lastname: Wang
authors.forename: Qin-shu
authors.initials: QS
authors.lastname: Shao
authors.forename: Qiong
authors.initials: Q
authors.lastname: Yang
authors.forename: Yuan-yu
authors.initials: YY
authors.lastname: Wang
authors.forename: Jin
authors.initials: J
authors.lastname: Yang
authors.forename: Zhong-kuo
authors.initials: ZK
authors.lastname: Zhao
authors.forename: Ji
authors.initials: J
authors.lastname: Xu
authors.forename: Zai-yuan
authors.initials: ZY
authors.lastname: Ye
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome