General and specific prognostic factors of early gastric carcinoma treated with curative surgery

BACKGROUND/AIMS: In Western countries as well as in Japan, the percentages of early gastric cancer (EGC) have been increasing. This study was performed to clarify the general and specific prognostic factors of EGC. METHODOLOGY: General prognostic factors were evaluated in 601 EGC patients treated with curative surgery, including those who died of unrelated causes, and specific prognostic factors were evaluated in 471 EGC patients, excluding those dying of unrelated causes, using univariate and multivariate analysis. RESULTS: The overall 5- and 10-year survival rates in the EGC patients were 86.7% and 76.6% respectively. In all 601 patients, including those who died of other causes, general prognostic factors, according to multivariate analysis, were sex, age, primary malignant diseases other than the original EGG, depth of invasion, and lymph node metastasis. The specific prognostic factor was lymph node metastasis with a risk ratio of 18.6-fold against patients without lymph node metastasis, according to multivariate analysis. CONCLUSIONS: The worst prognostic factors in all EGC patients were male sex, age 60 years and over, presence of primary malignant disease other than original EGG, submucosal cancer, and lymph node metastasis. Lymph node metastasis was specifically related to EGC recurrence. Thus, lymph node dissection is indispensable for the treatment of early gastric cancer, and the surveillance of other organs or the residual stomach for primary malignancy is particularly important after surgery.