Prognostic role of lymph node metastasis in early gastric cancer.
OBJECTIVE
To clarify the relationship between clinicopathological features and lymph node metastasis and to propose the potential indications of lymph node metastasis for prognosis in early gastric cancer (EGC) patients.


METHODS
We retrospectively observed 226 EGC patients with lymph node resection, and analyzed the associations between lymph node metastasis and clinicopathological parameters using the chi-square test in univariate analysis and logistic regression analysis in multivariate analysis. Overall survival analysis was determined using the Kaplan-Meier and log-rank test. We conducted multivariate prognosis analysis using the Cox proportional hazards model.


RESULTS
Of all the EGC patients, 7.5% (17/226) were histologically shown to have lymph node metastasis. The differentiation, lymphovascular invasion and depth of invasion were independent risk factors for lymph node metastasis in EGC. The 5- and 10-year survival rates were significantly lower in patients with lymph node metastasis than in those without and the patients also had shorter progress-free survival time. Lymph node metastasis and tumor size were independent prognostic factors for EGC. The status of the lymph nodes was a significant factor in predicting recurrence or metastasis after surgery.


CONCLUSIONS
The undifferentiated carcinoma and lymphovascular and/or submucosal invasion were associated with a higher incidence of lymph node metastasis in EGC patients, whom need to perform subsequent D2 lymphadenectomy or laparoscopic lymph node dissection and more rigorous follow-up or additional chemotherapy/radiation after D2 gastrectomy for poor prognosis and high recurrence/metastasis rate.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Department of Gastrointestinal Surgery, 2 Department of Pathology, 3 Clinical Gastric Cancer Translational Research Laboratory, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Zhixue
Z
Zheng
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Department of Gastrointestinal Surgery, 2 Department of Pathology, 3 Clinical Gastric Cancer Translational Research Laboratory, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Yiqiang
Y
Liu
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Department of Gastrointestinal Surgery, 2 Department of Pathology, 3 Clinical Gastric Cancer Translational Research Laboratory, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Zhaode
Z
Bu
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Department of Gastrointestinal Surgery, 2 Department of Pathology, 3 Clinical Gastric Cancer Translational Research Laboratory, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Lianhai
L
Zhang
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Department of Gastrointestinal Surgery, 2 Department of Pathology, 3 Clinical Gastric Cancer Translational Research Laboratory, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Ziyu
Z
Li
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Department of Gastrointestinal Surgery, 2 Department of Pathology, 3 Clinical Gastric Cancer Translational Research Laboratory, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Hong
H
Du
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 1 Department of Gastrointestinal Surgery, 2 Department of Pathology, 3 Clinical Gastric Cancer Translational Research Laboratory, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Jiafu
J
Ji
Early gastric cancer (EGC); lymph node metastasis; prognosis; recurrence