Abstract
BackgroundCurrent risk factors for lymph node metastasis in early gastric cancer have been primarily determined in Asian countries; however their applicability to Western nations is under discussion. The aim of our study was to identify risk factors associated with lymph node metastasis in Western cohort patients from the Eastern European country - Lithuania.MethodsA total of 218 patients who underwent open gastrectomy for early gastric cancer were included in this retrospective study. After histolopathological examination, risk factors for lymph node metastasis were evaluated. Overall survival was evaluated and factors associated with long-term outcomes were analyzed.ResultsLymph node metastases were present in 19.7% of early gastric cancer cases. The rates were 5/99 (4.95%) for pT1a tumors and 38/119 (31.9%) for pT1b tumors. Submucosal tumor invasion, lymphovascular invasion, and high grade tumor differentiation were identified as independent risk factors for lymph node metastasis. Submucosal tumor invasion and lymphovascular invasion were also associated with worse 5-year survival results.ConclusionOur study established submucosal tumor invasion, lymphovascular invasion, and high grade tumor differentiation as risk factors for lymph node metastasis.
Highlights
Current risk factors for lymph node metastasis in early gastric cancer have been primarily determined in Asian countries; their applicability to Western nations is under discussion
1654 patients with gastric adenocarcinoma were operated on at the institution during the study period. 1436 (86,8%) patients underwent surgery for advanced gastric cancer and 218 (13,2%) for early gastric cancer (EGC).EGC was defined as a cancer that does not invade past the submucosa, irrespective of regional lymph node metastasis (T1 any N)
Various clinicopathological parameters such as gender, age, primary tumor invasion, tumor differentiation grade, lymphatic and vascular invasion, tumor type according to Lauren classification, ulceration, tumor size and localization were evaluated as possible risk factors for lymph node metastasis (LNM)
Summary
Current risk factors for lymph node metastasis in early gastric cancer have been primarily determined in Asian countries; their applicability to Western nations is under discussion. The aim of our study was to identify risk factors associated with lymph node metastasis in Western cohort patients from the Eastern European country - Lithuania. The absence or presence of lymph node metastasis (LNM) must be confirmed to apply the treatment strategy. Lymph node status has great significance to the path of care chosen in early gastric cancer (EGC). It is important for proper treatment, and for the prognosis of survival [1, 2].
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