Frequency and Predictive Factors of Lymph Node Metastasis in Mucosal Cancer.
10.5230/jgc.2010.10.4.162
- Author:
Myung Jin NAM
1
;
Seung Jong OH
;
Cheong Ah OH
;
Dae Hoon KIM
;
Young Sik BAE
;
Min Gew CHOI
;
Jae Hyung NOH
;
Tae Sung SOHN
;
Jae Moon BAE
;
Sung KIM
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jhnoh@skku.edu
- Publication Type:Original Article
- Keywords:
Stomach neoplasms;
Gastric mucosa;
Lymphatic metastasis;
Predisposing factor
- MeSH:
Adenocarcinoma;
Gastrectomy;
Gastric Mucosa;
Humans;
Incidence;
Lymph Nodes;
Lymphatic Metastasis;
Multivariate Analysis;
Neoplasm Metastasis;
Neoplasm Staging;
Recurrence;
Retrospective Studies;
Stomach Neoplasms
- From:Journal of Gastric Cancer
2010;10(4):162-167
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The incidence of lymph node metastasis has been reported to range from 2.6 to 4.8% in early stage gastric cancer with mucosal invasion (T1a cancer). Lymph node metastasis in early stage gastric cancer is known as an important predictive factor. We analyzed the prediction factors of lymph node metastasis in T1a cancer. MATERIALS AND METHODS: A total of 9,912 patients underwent radical gastrectomy due to gastric cancer from October 1994 to July 2006 in the Department Of Surgery at Samsung Medical Center. We did a retrospective analysis of 2,524 patients of these patients, ones for whom the cancer was confined within the mucosa. RESULTS: Among the 2,524 patients, 57 (2.2%) were diagnosed with lymph node metastasis, and of these, cancer staging was as follows: 41 were N1, 8 were N2, and 8 were N3a. Univariate analysis of clinicopathological factors showed that the following factors were significant predictors of metastasis: tumor size larger than 4 cm, the presence of middle and lower stomach cancer, poorly differentiated adenocarcinoma and signet-ring cell carcinoma, diffuse type cancer (by the Lauren classification), and lymphatic invasion. Multivariate analysis showed that lymphatic invasion and tumor larger than 4 cm were significant factors with P<0.001 and P=0.024, respectively. CONCLUSIONS: The frequency of lymph node metastasis is extremely low in early gastric cancer with mucosal invasion. However, when lymphatic invasion is present or the tumor is larger than 4 cm, there is a greater likelihood of lymph node metastasis. In such cases, surgical treatments should be done to prevent disease recurrence.
