Skip to main content
SpringerLink
Log in

Prognostic Significance of Lymphovascular Invasion in Node-Negative Gastric Cancer

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to investigate the prognostic value of lymphovascular invasion (LVI) in gastric cancer patients without lymph node metastasis.

Methods

A total of 699 patients with primary tumor pT1–3/pN0-1 gastric adenocarcinoma who underwent curative resection from 2001 to 2010 were categorized into 3 groups: One-hundred and eleven patients with pN0/LVI(+), 475 with pN0/LVI(−), and 103 with pN1.

Results

The tumors in patients with N0/LVI(+) had more aggressive clinicopathologic features than those in patients with N0/LVI(−). However, there was no significant difference in patient characteristics between patients with pN0/LVI(+) and those with pN1, except for histologic grade. There were no significant differences in the overall survival rate in patients with pN0/LVI(+) compared to those with pN0/LVI(−) or the pN1 stage. However, the recurrence-free survival rate of the pN0/LVI(+) group was lower than that of the pN0/LVI(−) group (p < 0.001), while no significant difference was observed between the pN0/LVI(+) and the N1 groups (p = 0.216). In multivariate analysis, LVI was identified as a poor prognostic factor related to recurrence-free survival in node-negative gastric cancer patients. pT3 stage and less than D2 lymphadenectomy were poor prognostic factors affecting recurrence-free survival, and less than D2 lymphadenectomy was an independent poor prognostic factor for overall survival in pN0/LVI(+) patients.

Conclusions

LVI could be an indicator of biological aggressiveness and may be a reliable prognostic factor for node-negative gastric cancer. LVI should be considered in postoperative management of gastric cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Jemal A, Bray F, Center MM et al (2011) Global cancer statistics. CA Cancer J Clin 61(2):69–90

    Article  PubMed  Google Scholar 

  2. Kim JP, Lee JH, Kim SJ et al (1998) Clinicopathologic characteristics and prognostic factors in 10783 patients with gastric cancer. Gastric Cancer 1(2):125–133

    Article  PubMed  Google Scholar 

  3. Edge SB, Byrd DR, Compton CC et al (2010) American Joint Committee on Cancer, American Cancer Society: AJCC cancer staging manual, 7th edn. Springer, New York

    Google Scholar 

  4. Japanese Gastric Cancer Association (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 14(2):113–123

    Article  Google Scholar 

  5. Borie F, Millat B, Fingerhut A et al (2000) Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. Arch Surg 135(10):1218–1223

    Article  CAS  PubMed  Google Scholar 

  6. Chen R, He Q, Cui J et al (2014) Lymph node metastasis in early gastric cancer. Chin Med J (Engl) 127(3):560–567

    Google Scholar 

  7. Gotoda T, Yanagisawa A, Sasako M et al (2000) Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer 3(4):219–225

    Article  PubMed  Google Scholar 

  8. An JY, Baik YH, Choi MG et al (2007) Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 246(5):749–753

    Article  PubMed  Google Scholar 

  9. Liu C, Zhang R, Lu Y et al (2010) Prognostic role of lymphatic vessel invasion in early gastric cancer: a retrospective study of 188 cases. Surg Oncol 19(1):4–10

    Article  PubMed  Google Scholar 

  10. Ichikawa D, Kubota T, Kikuchi S et al (2009) Prognostic impact of lymphatic invasion in patients with node-negative gastric cancer. J Surg Oncol 100(2):111–114

    Article  PubMed  Google Scholar 

  11. Liu E, Zhong M, Xu F et al (2011) Impact of lymphatic vessel invasion on survival in curative resected gastric cancer. J Gastrointest Surg 15(9):1526–1531

    Article  PubMed  Google Scholar 

  12. Kunisaki C, Makino H, Kimura J et al (2010) Impact of lymphovascular invasion in patients with stage I gastric cancer. Surgery 147(2):204–211

    Article  PubMed  Google Scholar 

  13. Hyung WJ, Lee JH, Choi SH et al (2002) Prognostic impact of lymphatic and/or blood vessel invasion in patients with node-negative advanced gastric cancer. Ann Surg Oncol 9(6):562–567

    Article  PubMed  Google Scholar 

  14. Bu Z, Zheng Z, Li Z et al (2013) Lymphatic vascular invasion is an independent correlated factor for lymph node metastasis and the prognosis of resectable T2 gastric cancer patients. Tumour Biol 34(2):1005–1012

    Article  CAS  PubMed  Google Scholar 

  15. Yokota T, Kunii Y, Teshima S, et al (1999) Significant prognostic factors in patients with node-negative gastric cancer. Int Surg 84(4):331–336

  16. Lee IS, Yook JH, Kim TH et al (2013) Prognostic factors and recurrence pattern in node-negative advanced gastric cancer. Eur J Surg Oncol 39(2):136–140

    Article  CAS  PubMed  Google Scholar 

  17. Sakuramoto S, Sasako M, Yamaguchi T et al (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357(18):1810–1820

    Article  CAS  PubMed  Google Scholar 

  18. Bang YJ, Kim YW, Yang HK et al (2012) Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet 379(9813):315–321

    Article  CAS  PubMed  Google Scholar 

  19. Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma—2nd english edition. Gastric Cancer 1:10–24

    Article  PubMed  Google Scholar 

  20. Shen L, Shan YS, Hu HM et al (2013) Management of gastric cancer in Asia: resource-stratified guidelines. Lancet Oncol 14(12):e535–e547

    Article  PubMed  Google Scholar 

  21. Lim CS, Alexander-Sefre F, Allam M et al (2008) Clinical value of immunohistochemically detected lymphovascular space invasion in early stage cervical carcinoma. Ann Surg Oncol 15:2581–2588

    Article  PubMed  Google Scholar 

  22. O’Donnell RK, Feldman M, Mick R et al (2008) Immunohistochemical method identifies lymphovascular invasion in a majority of oral squamous cell carcinomas and discriminates between blood and lymphatic vessel invasion. J Histochem Cytochem 56:803–810

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

We have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Surgery, Hanyang University Seoul Hospital, Seoul, Republic of Korea

    Ju-Hee Lee, Min-Sung Jung & Sung Joon Kwon

  2. Department of Surgery, Hanyang University Guri Hospital, Seoul, Republic of Korea

    Min Gyu Kim

  3. Department of Surgery, College of Medicine, Hanyang University, 222 Wangsimri-ro, Seongdong-gu, Seoul, Republic of Korea

    Min Gyu Kim, Min-Sung Jung & Sung Joon Kwon

Authors
  1. Ju-Hee Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Min Gyu Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Min-Sung Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sung Joon Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sung Joon Kwon.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, JH., Kim, M.G., Jung, MS. et al. Prognostic Significance of Lymphovascular Invasion in Node-Negative Gastric Cancer. World J Surg 39, 732–739 (2015). https://doi.org/10.1007/s00268-014-2846-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-014-2846-y

Keywords

Search

Navigation