J Gastric Cancer.  2020 Mar;20(1):41-49. 10.5230/jgc.2020.20.e3.

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

• Fujita K
• Kanda M
• Ito S
• Mochizuki
• Teramoto H
• Ishigure K
• Murai T
• Asada T
• Ishiyama A
• Matsushita H
• Tanaka C
• Kobayashi
• Fujiwara M
• Murotani K
• Kodera Y

• KMID: 2471924
• DOI: http://doi.org/10.5230/jgc.2020.20.e3

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.

Keyword

Gastric cancer; Recurrence; Risk factor

MeSH Terms

Asian Continental Ancestry Group
Chemotherapy, Adjuvant
Dataset*
Gastrectomy
Humans
Multivariate Analysis
Prognosis
Recurrence*
Retrospective Studies
Risk Factors
Stomach Neoplasms*

Figure

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  Fig. 1 Flow diagram of the study.

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  Fig. 2 Association between LVI and disease recurrence. (A) Recurrence-free survival of patients with pT1N+ or pT2–3 N0 gastric cancer according to the LVI status. (B) Distribution of initial recurrence sites.LVI = lymphovascular invasion.*Two patients had multiple sites of first recurrence.

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