Lymph Node Metastasis, a Unique Independent Prognostic Factor in Early Gastric Cancer

作者：Bai-Wei Zhao, Yong-Ming Chen, Shan-Shan Jiang, Yin-Bo chen, Zhi-Wei Zhou, Yuanfang Li · 发表于：PLoS ONE · 年份：2015 · DOI：10.1371/journal.pone.0129531 · 被引用次数：74 · 研究领域：Gastric Cancer Management and Outcomes、Metastasis and carcinoma case studies、Esophageal Cancer Research and Treatment

BACKGROUND: Lymph node metastasis (LNM) has been shown to be related to the prognosis of early gastric cancer (EGC). The choice of optimal treatment depends on an accurate pre-operative assessment of LNM status in EGC patients. However, in China, where EGC cases account for only a small part of gastric cancer (GC) cases, there are not enough data to make an accurate assessment. Therefore, this study, which involved a relatively large number of EGC patients, aimed to explore the relationship between clinicopathological characteristics and LNM in EGC. METHODS: Clinicopathological data from 205 EGC patients who underwent surgical resection at Sun Yat-Sen University Cancer Center from January 2000 to December 2011 were retrospectively analyzed. Clinicopathological characteristics were assessed to identify effective predictive factors for LNM and overall survival. RESULTS: LNM occurred in 52 (25.37%) EGC cases; of these cases, 18 occurred in intra-mucosal cancers (13 N1, 4 N2 and 1 N3), and 34 occurred in sub-mucosal cancers (22 N1, 7 N2 and 5 N3). Logistic regression analysis demonstrated that tumor differentiation (P=0.002), depth of tumor infiltration (P=0.004), vessel invasion (P=0.012), tumor size (P=0.020) and gender (P=0.022) were risk factors associated with LNM in EGC, listed in order of priority. The overall survival rate was 90.2%. Kaplan-Meier survival analysis showed that overall survival of EGC patients was significantly correlated with LNM (P=0.001), N staging (P<0....