Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Prognostic Significance of Lymphatic and Perineural Invasions in Patients with Gastric Cancer Who Have No Lymph Node and Serosal Involvement

장막 침윤과 림프절 전이가 없는 위암에서 림프관 및 신경초 침윤의 의의

  • Kim Wook (Department of Surgery, The Catholic University of Korea) ;
  • Park Cho Hyun (Department of Surgery, The Catholic University of Korea) ;
  • Park Seung Man (Department of Surgery, The Catholic University of Korea) ;
  • Park Woo Bai (Department of Surgery, The Catholic University of Korea) ;
  • Lim Keun Woo (Department of Surgery, The Catholic University of Korea) ;
  • Kim Seung Nam (Department of Surgery, The Catholic University of Korea)
  • 김욱 (가톨릭대학교 의과대학 외과학교실) ;
  • 박조현 (가톨릭대학교 의과대학 외과학교실) ;
  • 박승만 (가톨릭대학교 의과대학 외과학교실) ;
  • 박우배 (가톨릭대학교 의과대학 외과학교실) ;
  • 임근우 (가톨릭대학교 의과대학 외과학교실) ;
  • 김승남 (가톨릭대학교 의과대학 외과학교실)
  • Published : 2001.06.01
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Abstract

Purpose: The most important prognostic factors in gastric cancer are depth of invasion and lymph node metastasis. Therefore, the prognosis for serosa and lymph node negative gastric cancer is favorable. However, there is no general agreement on the prognostic factors in this subset of patients. This study was undertaken to evaluate the prognostic significances of venous invasion (VI), lymphatic invasion (LI), and perineural invasion (NI) in T1 and T2 gastric cancer without lymph node involvement. Materials and Methods: We retrospectively evaluated 206 patients with T1 and T2, lymph node negative gastric cancer who underwent a curative resection from 1989 to 1993 at Kangnam St. Mary's Hospital, Seoul, Korea. The Chi-square test was used to determine the statistical significance of differences, and the Kaplan-Meier method was used to calculate survival rates. Significant differences in the survival rates were assessed using the log-rank test, and the Cox regression method was used to evaluate independent prognostic significance. Results: The rate of VI, LI and NI correlated well with the depth of tumor invasion. The rates of VI (+) for T1 vs T2 was $0\%\;vs\;5.1\%$, of LI (+) was $5.6\%\;vs\;26.8\%$, and of NI (+) was $1.6\%\;vs\;26.8\%$ in NI (+). There were 13 recurrent cases, 10 cases out of the 13 were T2 gastric cancers, and the recurrence rate was higher in LI (+) and NI (+) cases than in LI (-) and NI (-) cases. The 5-year survival rates were $93.4\%$ in LI (-) cases, $77.4\%$ in LI (+) cases, $92.5\%$ in NI (-) cases, $74\%$ in NI(+) cases, $95.9\%$ in LI (-) NI (-) cases, and $73.9\%$ in LI (+) NI (+) cases. Multivariate analysis demonstrated that simultaneous LI and NI was the only significant factor influencing the prognosis. Conclusion: These results suggest that simultaneous lymphatic and perineural invasion may be an independent prognostic factor in patients with T1 and T2 gastric cancer without lymph node metastasis.

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