Predictive Factors for Lymph Node Metastasis in Early Gastric Cancer

ABSTRACT

This report is a clinical review of 298 cases of early gastric cancer that were treated at Kosin Medical Hospital during 8 years from 1984 to 1992. In 1962, the Japanese Gastroenterological Endoscopy Society defined early gastric cancer as a lesion confined to the mucosa or submucosa and not related to the presence of lymph-node metastasis. The prognosis for early gastric cancer (EGC) is generally excellent, but the proportion of EGC cases progressing to advanced gastric cancer is steadily increasing nowadays. The presence or absence of lymph-node metastasis in EGC is an important prognostic factor; in other words, the survival rate or recurrence rate of node-negative EGC is known to be much better than that of node-positive EGC. The incidence of EGC among resected gastric cancers was 14.7%, and has been increasing annually. The mean age of the EGC patient was 52.4 years, and the most common type was IIc. The size of the lesion was variable, but the most common range was 1~3 cm. Lymph-node metastasis accurred more frequently with the larger sized lesions. In this study, several factors such as age, sex, tumer location, tumer size, depth of invasion, macroscopic and histologic type were evaluated to determine frequency of lymph node metastasis. In the analysis of these eight facters, sex, tumer size, depth of invasion and Lauren type were statistically correlated with lymp node metastasis.