Relationship between the clinicopathological features and prognosis in patients with early gastric cancer

Objective To discuss the relationship between the clinicopathological features and prognosis of early gastric cancer cases,and to analyze the status of lymph node metastasis in patients with early gastric cancer,so as to provide the basis for the application of minimally invasive therapy and reducing rationally the scale of surgical procedures.Methods The clinicopathological data of 231 EGC cases submitted to radical resection from Jan 2003 to Sep 2008 were analyzed retrospectively.Univariate and multivariate analysis were used to study the relationship between the clinicopathological features and the outcome of the patients.Results Univariate analysis showed that the prognosis of early gastric cancer was related to the tumor size,depth of invasion and status of lymph node metastasis.Multivariate analysis showed that the status of lymph node matastasis was the only independent prognostic factor.The incidence of lymph node metastasis in primary early gastric cancer was(36/231,15.6%),that of the intramucosal invasive gastric cancer was(4/70,5.7%),while in cases in which the the submucosa were involved was(32/161,19.9%).Logistic regression analysis showed that tumor size over 2 cm and infiltration into the submucosa were the risk factors of the lymph node metastasis.In patients with early gastric cancer and no lymph node metastasis,the survival rate 3 years after surgery was 98.6%,significantly better than those with lymph node metastasis(P0.05).In patients with 1～3 positive lymph nodes,their survival rate 3 years after surgery was 95.0%,and in patients with 4 positive lymph nodes,their survival 3 years after surgery was only 44.4%.Hematogenous metastasis was another main postoperative recurrent approach for early gastric cancer cases.Conclusions The status of lymph node metastasis is the key indicator of the prognosis of early gastric cancer;tumor size( 2 cm) and infiltration into the submucosa are the independent risk factors to the status of lymph node metastasis in early gastric cancer.Pre-operative usage of the imaging technology would be a valuable means to predict the status of lymph node metastasis and to help designing an appropriate therapeutic strategy.