Prognostic role of lymphatic vessel invasion in early gastric cancer: A retrospective study of 188 cases

Abstract 

Background

Lymphatic vessel invasion is an important prognostic factor for the gastric cancer without lymph node metastasis. However, the studies on early gastric cancers is still sparse. Therefore, we carried out this study to determine clinicopathological and surgical prognostic factors, especially lymphatic vessel invasion, for early gastric cancers.

Methods

Clinicopathological characteristics and prognostic outcomes of 188 patients who received a gastrectomy for early gastric cancer between 1980 and 2000 were retrospectively evaluated based on the subclassification of pN category. A multivariate analysis was performed by using the Cox regression model, where lymphatic vessel invasion and other potential prognostic factors were included.

Results

Of the 188 patients, 158 had T1N0M0 and 30 T1N1M0 cancers. In patients with T1N0M0 cancers, the survival rate was significantly lower in those with lymphatic vessel invasion than in those without (χ²=4.025, P=0.045). However, in patients with T1N1M0 cancers, the survival rates were not significantly different between those with and those without lymphatic vessel invasion (χ²=0.253, P=0.615). The multivariate analysis identified that age (P=0.033) and lymph node metastasis (P=0.019) were independent prognostic factors for all early gastric cancers. However, age (P=0.042), tumor location (P=0.032), and lymphatic vessel invasion (P=0.010) were the independent prognostic factors for T1N0M0 cancers.

Conclusions

Lymphatic vessel invasion was an independent prognostic factor for T1N0M0 early gastric cancers, and thus may be a potential prominent factor that should be considered to be included in the category of lymphoid metastasis (both lymph node metastasis and lymphatic vessel invasion) in patients with early gastric cancer.

Keywords: Early gastric cancer, TNM, Lymphatic vessel invasion, Survival