Impact of lymphovascular invasion in patients with stage I gastric cancer

Kunisaki, Chikara; Makino, Hirochika; Kimura, Jun; Takagawa, Ryo; Kosaka, Takashi; Ono, Hidetaka A.; Akiyama, Hirotoshi; Fukushima, Tadao; Nagahori, Yutaka; Takahashi, Masazumiu

doi:10.1016/j.surg.2009.08.012

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Volume 147, Issue 2 , Pages 204-211, February 2010

Impact of lymphovascular invasion in patients with stage I gastric cancer

Chikara Kunisaki, MD, PhD
- Department of Surgery, Gastroenterological Center, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
- Reprint requests: Chikara Kunisaki, MD, PhD, Department of Surgery, Yokohama City University, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.
Hirochika Makino, MD, PhD
- Department of Surgery, Gastroenterological Center, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
Jun Kimura, MD
- Department of Surgery, Gastroenterological Center, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
Ryo Takagawa, MD
- Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
Takashi Kosaka, MD
- Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
Hidetaka A. Ono, MD, PhD
- Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
Hirotoshi Akiyama, MD, PhD
- Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan
Tadao Fukushima, MD, PhD
- Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
Yutaka Nagahori, MD, PhD
- Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan
Masazumiu Takahashi, MD, PhD
- Department of Surgery, Yokohama Municipal Hospital, Yokohama, Japan

Accepted 28 August 2009. published online 02 November 2009.

Background

Patients with stage I gastric cancer often suffer from tumor recurrence despite a generally favorable operative outcome. It is therefore important to determine the prognostic factors in order to improve such outcomes.

Methods

Between April 1985 and March 2000, a total of 1,880 patients with histologically proven stage I gastric cancer were included in this study. Operative outcomes (survival time, prognostic factors, pattern of recurrence) were evaluated in these patients.

Results

Multivariate analysis in patients with all stage I gastric cancer revealed that depth of invasion, lymph node metastasis, and lymphovascular invasion independently influenced prognosis. Moreover, advanced age was selected as an independent prognostic factor in patients with stage IA, and lymphovascular invasion in patients with stage IB gastric cancer by multivariate analyses. The 5-year survival rates in stage T1N1 patients with moderate to severe lymphovascular invasion, T2N0 with moderate to severe lymphovascular invasion, and II were 95.1%, 83.5%, and 76.9%, respectively. There was a significant difference in survival time between stage T1N1 and II (P = .0189) but not between stage T1N1 and T2N0 or stage T2N0 and II.