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Prognostic Significance of Lymphovascular Invasion in Node-Negative Gastric Cancer

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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.

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Correspondence to Sung Joon Kwon.

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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

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

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