Prognostic Significance of Lymph Node Micrometastasis in pT2N0 Gastric Cancer

Lee, Hyeon Kook; Cho, Sam Je; Kim, Yoon Ho; Lee, Hye Seung; Kim, Woo Ho; Lee, Kuhn Uk; Choe, Kuk Jin; Kim, Jin Pok; Yang, Han Kwang

Abstract

PURPOSE: The prognostic significance of lymph node (LN) micrometastasis in gastric cancer remains contro versial. We therefore investigated the clinicopathologic factors related to LN micrometastasis and evaluated the clinical relevance of micrometastasis with regard to urrence.
MATERIALS AND METHODS
A total of 1083 LNs from 39 patients with pT2N0 gastric cancer and who underwent curative resection in 1993 were further immunohistochemically stained using an anti-cytokeratin Ab cocktail (AE1-AE3).
RESULTS
Micrometastases were found in 3.9% (42/1083) of the resected LNs and 53.8% (21/39) of the patients with pT2N0 gastric cancer. LN micrometastasis was found to be significantly related with histologic differentiation. The recurrence rate of gastric cancer was higher in patients with LN micrometastasis (31.6%) than in those without (6.3%), with a borderline significance (p=0.074). In uni variate analysis, patients with LN micrometastasis had a shorter 5-year disease-free survival (65%) than those without LN micrometastasis (87%) (p=0.075). In multivariate analysis, multiple LN micrometastasis was associated with a poor prognosis, but with a borderline significance (p=0.069, Risk ratio 4.815)
CONCLUSION
We were able to identify LN micrometastases missed on routine H-E staining, using an immuno histochemical technique. Our results suggest that LN micrometastasis is associated with the recurrence of pT2N0 gastric cancer.