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Association between Lymphovascular Invasion and Recurrence in Patients with pT1N+ or pT2-3N0 Gastric Cancer: a Multi-institutional Dataset Analysis

  • Fujita, Keizo (Department of Surgery, Ichinomiya Municipal Hospital) ;
  • Kanda, Mitsuro (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Ito, Seiji (Department of Gastroenterological Surgery, Aichi Cancer Center) ;
  • Mochizuki, Yoshinari (Department of Surgery, Komaki Municipal Hospital) ;
  • Teramoto, Hitoshi (Department of Surgery, Yokkaichi Municipal Hospital) ;
  • Ishigure, Kiyoshi (Department of Surgery, Konan Kosei Hospital) ;
  • Murai, Toshifumi (Department of Surgery, Ichinomiya Municipal Hospital) ;
  • Asada, Takahiro (Department of Surgery, Gifu Prefectural Tajimi Hospital) ;
  • Ishiyama, Akiharu (Department of Surgery, Okazaki City Hospital) ;
  • Matsushita, Hidenobu (Department of Surgery, Tosei General Hospital) ;
  • Tanaka, Chie (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Kobayashi, Daisuke (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Fujiwara, Michitaka (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Murotani, Kenta (Biostatistics Center, Graduate School of Medicine, Kurume University) ;
  • Kodera, Yasuhiro (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
  • Received : 2019.09.18
  • Accepted : 2019.12.16
  • Published : 2020.03.31

Abstract

Purpose: Patients with pathological stage T1N+ or T2-3N0 gastric cancer may experience disease recurrence following curative gastrectomy. However, the current Japanese Gastric Cancer Treatment Guidelines do not recommend postoperative adjuvant chemotherapy for such patients. This study aimed to identify the prognostic factors for patients with pT1N+ or pT2-3N0 gastric cancer using a multi-institutional dataset. Materials and Methods: We retrospectively analyzed the data obtained from 401 patients with pT1N+ or pT2-3N0 gastric cancer who underwent curative gastrectomy at 9 institutions between 2010 and 2014. Results: Of the 401 patients assessed, 24 (6.0%) experienced postoperative disease recurrence. Multivariate analysis revealed that age ≥70 years (hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.09-7.23; P=0.030) and lymphatic and/or venous invasion (lymphovascular invasion (LVI): HR, 7.88; 95% CI, 1.66-140.9; P=0.005) were independent prognostic factors for poor recurrence-free survival. There was no significant association between LVI and the site of initial recurrence. Conclusions: LVI is an indicator of poor prognosis in patients with pT1N+ or pT2-3N0 gastric cancer.

Keywords

References

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