Abstract
Background Lymph node metastasis (LNM) is the most important risk factor for endoscopic treatment in early gastric cancer (EGC) patients. We aimed to investigate the rate of LNM, the risk factors, and the prognosis of EGC patients with LMN. Methods A total of 10,039 patients who underwent gastrectomy with lymphadenectomy were reviewed between January 2010 and December 2015 at Jiangsu Province Hospital in China. Among them, we identified 1004 (10%) EGCs. First, endoscopic and clinicopathological features related to LNM were analyzed, and then risk factors for LNM were identified using univariate and multivariate analysis. Finally, the short- and long-term outcomes were compared between the groups. Results LNM occurred in 123 (12.3%) EGCs. Most of EGCs were male (n = 720, 71.7%) and mean age was 59.65 ± 11.09 years. The rate of H. pylori infection was 78.0% (783/1004). LNM was significantly associated with age, sex, location, lesion size, macroscopic type, depth of invasion, differentiation type, histological morphology, lymphovascular invasion (LVI), and TMN stage. By multivariate analysis, significant independent risk factors for LNM in EGC were identified as following: male sex (OR 2.365, P = 0.035), age ≦ 40 (OR 0.055, P = 0.012), depressed type (OR 2.721, P = 0.013), submucosa invasion (OR 2.987, P = 0.032), LVI (OR 5.186, P = 0.003), tumor located in corpora (OR 8.904, P = 0.047), and in angle (OR 12.998, P = 0.024). 86.5% were successfully followed up for 3 years. The overall 1- and 3-year survival rates in LNM group were 100% and 91.1%, respectively, and those with no LNM were 100% and 100%, respectively. Conclusion EGCs were investigated in 10.0% of gastric cancer, which LNM occurred in 12.3% of EGC. Independent risk factors of LNM included male sex, age (>40), the depth of invasion, LVI, and tumor located in corpora or angle. The 3-year overall survival rate was greater in EGC patients without LNM.
Highlights
Gastric cancer (GC) is one of the most prevalent malignancies in Eastern Asia [1], and the incidence of GC has been increasing in keeping with the aging [2]
A total of 1004 (10.0%) patients with early gastric cancer (EGC) were enrolled in our study, including Lymph node metastasis (LNM) (n = 123) and without LNM (n = 881)
Significant independent risk factors for LNM in EGC were identified as following: male sex, age ≦ 40, depressed type, submucosa invasion, lymphovascular invasion (LVI), tumor located in corpora, and tumor located in angle (Table 4)
Summary
Gastric cancer (GC) is one of the most prevalent malignancies in Eastern Asia [1], and the incidence of GC has been increasing in keeping with the aging [2]. Lymph node metastasis (LNM) is the most important risk factor for endoscopic treatment in early gastric cancer (EGC) patients. Significant independent risk factors for LNM in EGC were identified as following: male sex (OR 2.365, P = 0 035), age ≦ 40 (OR 0.055, P = 0 012), depressed type (OR 2.721, P = 0 013), submucosa invasion (OR 2.987, P = 0 032), LVI (OR 5.186, P = 0 003), tumor located in corpora (OR 8.904, P = 0 047), and in angle (OR 12.998, P = 0 024). Independent risk factors of LNM included male sex, age (>40), the depth of invasion, LVI, and tumor located in corpora or angle. The 3-year overall survival rate was greater in EGC patients without LNM
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