Surgical outcome in early gastric cancer with lymph node metastasis

Background/Aims: Definitive surgical management of early gastric cancer with lymph node metastasis has not been established. This paper describes the clinico-pathologic characteristics of early gastric cancer with lymph node metastasis. Materials and Methods: A retrospective study of early gastric cancer with lymph node metastasis (32 patients) was performed to compare clinico-pathologic features with patients without lymph node metastasis (283 patients). Results: All patients with lymph node metastasis had submucosal gastric invasion. The incidence of histologically proven. curative resection in patients with lymph node metastasis was significantly lower than in those without metastasis (40.6 % versus 93.3 %). The 5-year survival rate was poorer in patients with positive nodes than in those with negative nodes (83.8 % versus 96.2 %). Recurrence was more frequent in patients with involved nodes (12.5 % versus 0.4 %). Lymph node metastasis was more frequent with the following: submucosal invasion, tumor over 5 cm in size, positive venous involvement, and an advanced growth pattern. Conclusions: Pre-operative and intra-operative evaluation for lymph node metastasis is essential for the appropriate surgical treatment of early gastric cancer.