Abstract
PurposeTo investigate the correlated factors for lymph node metastasis and prognosis for patients with T2 gastric cancer.MethodsA total of 442 patients with T2 gastric cancer who underwent gastrectomy from January 1996 to December 2009 were evaluated. The clinicopathological parameters were analyzed for lymph node metastasis and prognosis, including gender, age, tumor size, tumor location, histological type, depth of invasion, vascular tumor emboli, nervous invasion, resection type, and pathological stage.ResultsThe rate of lymph node metastasis was 45.9%. Univariate analysis showed that depth of invasion, tumor size, and vascular tumor emboli were associated with lymph node metastasis. Logistic regression demonstrated that depth of invasion, tumor size, and vascular tumor emboli were independently predictive factors for lymph node metastasis. The 5-year survival rate was 64.0%. Multivariate analysis showed that tumor size, tumor location, resection type, and pathological stage were independent prognostic factors. Based on tumor size, there were significant differences of 5-year survival between small size tumor (<6 cm) and large size tumor (≥6 cm) according to stage IIA (P = 0.006). Based on tumor location, there were significant differences of 5-year survival among different tumor location according to stage IB. Based on resection type, there were significant differences of overall 5-year survival between curative surgery and palliative surgery according to stage IIB (P = 0.015) and IIIA (P = 0.001).ConclusionDepth of invasion, tumor size, and vascular tumor emboli were independently predictive factors for lymph node metastasis. Tumor size, tumor location, resection type, and pathological stage were independent prognostic factors.
Highlights
The incidence of gastric cancer has been dramatically declining for past several decades, it remains the fourth most common cancer and the second most frequent cause of cancerrelated death worldwide [1,2]
Univariate analysis showed that depth of invasion, tumor size, vascular tumor emboli were associated with lymph node metastasis, whereas age, gender, histological type, tumor location, and nervous invasion were not (Table 2)
We found that depth of invasion, tumor size, vascular tumor emboli were associated with lymph node metastasis
Summary
The incidence of gastric cancer has been dramatically declining for past several decades, it remains the fourth most common cancer and the second most frequent cause of cancerrelated death worldwide [1,2]. Some studies have indicated that the depth of invasion and the status of lymph node metastasis were the most important prognostic factors in gastric cancer [7,8]. There was a significant modification in T2 stage between the sixth and seventh UICC/ AJCC TNM classification. In the former, the T2 stage indicated that tumor extended into the muscularis propria (MP) or subserosa (SS) layer. There were relatively limited studies reporting the clinicopathological characteristics and prognosis of patients with T2 stage gastric cancer in the seventh UICC stage system. We evaluated the correlated factors for lymph node metastasis and prognosis in patients with T2 gastric cancer
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