Skip to main content
SpringerLink
Log in

Predictable Factors for Lymph Node Metastasis in Early Gastric Cancer—Analysis of Single Institutional Experience

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Introduction

Prediction of lymph node metastasis in early gastric cancer (EGC) is very important to decide treatment strategies preoperatively. The aim of this study was to evaluate factors that predict the presence of lymph node metastasis and to indentify the differences between mucosal and submucosal gastric cancers.

Methods

A total of 376 patients with EGC who underwent gastrectomy from March 1999 through December 2007 were retrospectively identified. The clinopathological factors and biological markers (p53, Ki67) were analyzed.

Results

The rate of lymph node metastasis was 9.6% (mucosal cancer 2.8%, submucosal cancer 18.4%). Tumor size, depth of invasion, macroscopic type, and lymphovascular invasion were related to lymph node metastasis in EGC. When the carcinomas were confined to the mucosal layer, tumor size and lymphovascular invasion showed significant correlation with lymph node metastasis. On the other side, macroscopic type and lymphovascular invasion were association with lymph node metastasis in submucosal carcinoma.

Conclusion

The risk factors for lymph node metastasis in EGC are quite different depending on depth of tumor invasion. To predict lymph node metastasis in EGC, it is recommended that distinct assessment according to individual situation should be clearly established.

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

Similar content being viewed by others

References

  1. Kajitani T. The general rules for the gastric cancer study in surgery and pathology. Part I. Clinical classification. Jpn J Surg 1981;11:127–139.

    Article  PubMed  CAS  Google Scholar 

  2. Borie F, Millat B, Fingerhut A, Hay JM, Fagniez PL, De Saxce B. Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. Arch Surg 2000;135:1218–1223.

    Article  PubMed  CAS  Google Scholar 

  3. Roviello F, Rossi S, Marrelli D, Pedrazzani C, Corso G, Vindigni C, Morgagni P, Saragoni L, de Manzoni G, Tomezzoli A. Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study. J Surg Oncol 2006;94:275–280.

    Article  PubMed  Google Scholar 

  4. Pelz J, Merkel S, Horbach T, Papadopoulos T, Hohenberger W. Determination of nodal status and treatment in early gastric cancer. Eur J Surg Oncol 2004;30:935–941.

    Article  PubMed  CAS  Google Scholar 

  5. Kim DY, Joo JK, Ryu SY, Kim YJ, Kim SK. Factors related to lymph node metastasis and surgical strategy used to treat early gastric carcinoma. World J Gastroenterol 2004;10:737–740.

    PubMed  Google Scholar 

  6. Hyung WJ, Cheong JH, Kim J, Chen J, Choi SH, Noh SH. Application of minimally invasive treatment for early gastric cancer. J Surg Oncol 2004;85:181–185.

    Article  PubMed  Google Scholar 

  7. Park DJ, Lee HK, Lee HJ, Lee HS, Kim WH, Yang HK, Lee KU, Choe KJ. Lymph node metastasis in early gastric cancer with submucosal invasion: feasibility of minimally invasive surgery. World J Gastroenterol 2004;10:3549–552.

    PubMed  Google Scholar 

  8. An JY, Baik YH, Choi MG, Noh JH, Sohn TS, Kim S. Predictive factors for lymph node metastasis in early gastric cancer with submucosal invasion: analysis of a single institutional experience. Ann Surg 2007;246:749–753.

    Article  PubMed  Google Scholar 

  9. Fenoglio-Preiser CM, Wang J, Stemmermann GN, Noffsinger A. TP53 and gastric carcinoma: a review. Hum Mutat 2003;21:258–270.

    Article  PubMed  CAS  Google Scholar 

  10. Xiangming C, Hokita S, Natsugoe S, Tanabe G, Baba M, Takao S, Kuroshima K, Aikou T. Cooccurrence of reduced expression of alpha-catenin and overexpression of p53 is a predictor of lymph node metastasis in early gastric cancer. Oncology 1999;57:131–137.

    Article  PubMed  CAS  Google Scholar 

  11. Weigel MT, Dowsett M. Current and emerging biomarkers in breast cancer: prognosis and prediction. Endocr Relat Cancer 2010;17:R245-262.

    Article  PubMed  CAS  Google Scholar 

  12. Goishi H, Tanaka S, Haruma K, Yoshihara M, Sumii K, Kajiyama G, Shimamoto F. Predictive value of cathepsin D and Ki-67 expression at the deepest penetration site for lymph node metastases in gastric cancer. Oncol Rep 2000;7:713–18.

    PubMed  CAS  Google Scholar 

  13. Roukos DH. Current advances and changes in treatment strategy may improve survival and quality of life in patients with potentially curable gastric cancer. Ann Surg Oncol 1999;6:46–56.

    Article  PubMed  CAS  Google Scholar 

  14. Korean Cancer Center Registry. Ministry of Health and Welfare Republic of Korea. Annual report of Korea Central Cancer Registry 2005.

  15. The Information Committee of the Korean Gastric Cancer Association. 2004 Nationwide gastric cancer report in Korea. J Korean Gastric Cancer Assoc 2007;7:47–54.

    Google Scholar 

  16. Noh SH, Hyung WJ, Cheong JH. Minimal invasive treatment for gastric cancer: approaches and selection process. J Surg Oncol 2005;90:188–193.

    Article  PubMed  Google Scholar 

  17. Sano T, Kobori O, Muto T. Lymph node metastasis from early gastric cancer: endoscopic resection of tumor. Br J Surg 1992;79:241–244.

    Article  PubMed  CAS  Google Scholar 

  18. Adachi Y, Shiraishi N, Kitano S. Modern treatment of early gastric cancer: review of the Japanese experience. Dig Surg 2002;19:333–339.

    Article  PubMed  Google Scholar 

  19. Okabayashi T, Kobayashi M, Sugimoto T, Okamoto K, Hokimoto N, Araki M. Clinicopathological investigation of early gastric carcinoma; is less invasive surgery right for early gastric carcinoma. Hepatogastroenterology 2007;54:609–612.

    PubMed  Google Scholar 

  20. Shen L, Huang Y, Sun M, Xu H, Wei W, Wu W. Clinicopathological features associated with lymph node metastasis in early gastric cancer: analysis of a single institution experience in China. Can J Gastroenterol 2009;23:353–356.

    PubMed  Google Scholar 

  21. Li C, Kim SS, Lai JF, Oh SJ, Hyoung WJ, Choi WH, Choi SH, Zhu ZG, Noh SH. Risk factors for lymph node metastasis in undifferentiated early gastric cancer. Ann Surg Oncol 2008;15:764–769.

    Article  PubMed  Google Scholar 

  22. Song SY, Park S, Kim S, Son HJ, Rhee JC. Characteristics of intramucosal gastric carcinoma with lymph node metastatic disease. Histopathology 2004;44:437–444.

    Article  PubMed  CAS  Google Scholar 

  23. Ohashi S, Okamura S, Urano F, Maeda M. Clinicopathological variables associated with lymph node metastasis in submucosal invasive gastric cancer. Gastric Cancer 2007;10:241–250.

    Article  PubMed  Google Scholar 

  24. Bryne M, Boysen M, Alfsen CG, Abeler VM, Sudbø J, Nesland JM, Kristensen GB, Piffko J, Bankfalvi A et al. The invasive front of carcinomas. The most important area for tumour prognosis? Anticancer Res 1998;18:4757–4764.

    PubMed  CAS  Google Scholar 

  25. Levine AJ, Momand J, Finlay CA. The p53 tumor suppressor gene. Nature 1991;351:453–456.

    Article  PubMed  CAS  Google Scholar 

  26. Gerdes J, Lemke H, Baisch H, Wacker HH, Schwab U, Stein H. Cell cycle analysis of cell proliferation-associated human nuclear antibody Ki-67. J Immunol 1984;133:1710–1715.

    PubMed  CAS  Google Scholar 

  27. Mita T, Shimoda T. Risk factors for lymph node metastasis of submucosal invasive differentiated type gastric carcinoma: clinical significance of histological heterogeneity. J Gastroenterol 2001;36:661–668.

    Article  PubMed  CAS  Google Scholar 

  28. Pan W, Ishil H, Ebihara Y, Gobe G. Prognostic use of growth characteristics of early gastric cancer and expression patterns of apoptotic, cell proliferation, and cell adhesion proteins. J Surg Oncol 2003;82:104–110.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Hallym University Sacred Heart Hospital, 896 Pyungchon-dong, Dongan-gu, Anyang, Gyeonggi, 431-070, South Korea

    Man Sup Lim, Byung Seup Kim, Mi Yeol Lee, Jang Yong Jeon & Bong Hwa Lee

  2. Department of Surgery, Hallym University Hangang Sacred Heart Hospital, 94-200, Yeongdeungpo-dong, Yeongdeungpo-gu, Seoul, 150-719, South Korea

    Hae-Wan Lee

  3. Department of Occupation and Environmental Medicine, Hallym University Sacred Heart Hospital, 896 Pyungchon-dong, Dongan-gu, Anyang, Gyeonggi, 431-070, South Korea

    Hyoungjune Im

  4. Department of Surgery, Hallym University Kangnam Sacred Heart Hospital, 948-1, Daerim-dong, Yeongdeungpo-gu, Seoul, 150-950, South Korea

    Dae Hyun Yang

Authors
  1. Man Sup Lim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hae-Wan Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hyoungjune Im
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Byung Seup Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mi Yeol Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jang Yong Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Dae Hyun Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bong Hwa Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hae-Wan Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lim, M.S., Lee, HW., Im, H. et al. Predictable Factors for Lymph Node Metastasis in Early Gastric Cancer—Analysis of Single Institutional Experience. J Gastrointest Surg 15, 1783–1788 (2011). https://doi.org/10.1007/s11605-011-1624-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-011-1624-5

Keywords

Search

Navigation