Characteristics of patients with early gastric cancer who had undergone surgery in single institute

Abstract

15535 Background: The incidence of early gastric cancer (EGC) has been increasing worldwide owing to advances with diagnositic techniques and screening programs. Radical gastrectomy with lymph node dissection is still the gold-standard treatment for EGC. The present study was designed to investigate the characteristics of EGC patients who had undergone surgery. Methods: According to the Japanese classification of gastric carcinoma, EGC is defined as a lesion confined to the mucosa or submucosa, regardless of the presence of regional lymph node metastasis. We reviewed 529 patients with gastric cancer who had undergone gastrectomy at Ulsan University Hospital, Ulsan, Korea, from December 2002 to December 2005. Results: Two hundred sixty-one patients (49%) were diagnosed as EGC (155 intramucosal EGC (mEGC), 106 intrasubmucosal EGC (smEGC), 123 differentiated EGC, and 138 undifferentiated EGC). One hundred sixty-one patients (61.7%) were male and median age was 55. The mean diameter of tumor was 2.49 ± 1.55 cm (2.18 ± 1.45 cm in mEGC and 2.94 ± 1.60 cm in smEGC, p=0.000). The incidence of lymph node metastasis was 11.5% (30 out of 261 patients). Univariate analysis revealed that a tumor larger than 2 cm (17.6% vs. 6.3%), submucosal invasion (20.8% vs. 5.2%), and the presence of lymphovascular invasion (LVI) (33.3% vs. 6.6%) were significantly associated with a higher lymph node metastasis rate. There were no significant associations between lymph node metastasis and differentiation, age, gender, tumor location, macroscopic type, CEA level,or CA19- 9 level. In multivariate analysis, LVI was independent predictive factor for lymph node metastasis (p=0.005), while submucosal invasion was marginally predictive (p=0.069) and tumor size was not (p=0.208). At a median follow-up of 1023 days, only 2 patients relapsed and 1 patient died due to disease progression. Conclusions: LVI was independent predictive factor for lymph node metastasis. In cases that LVI was present after endoscopic resection, radical gastrectomy should be recommended. Endoscopic resection data will be analyzed and compared with surgery data. No significant financial relationships to disclose.