A study on related risk factors and prognosis for lymph node metastasis in patients with early gastric cancer

The aim of this study was to analyze the risk factors and prognosis for lymph node metastasis (LNM) in patients with early gastric cancer (EGC) in order to provide theoretical evidence for establishing a reasonable therapeutic schedule. This study retrospectively reviewed 112 patients who underwent surgery (open or laparoscopic). Clinical characteristics and pathological features were analyzed by using Chi-square and binary logistic regression. Survival data for the operated patients were analyzed using the Kaplan-Meier method. Logistic regression analysis revealed that age, depth of infiltration, neoplasms by histological type and lymphatic embolus were independent risk factors for LNM. Furthermore, no LNM was observed in patients who had mucousal cancer, were over 60 years old, and had a highly differentiated tumor without lymphatic embolus. However, LNM occurred when neoplasms infiltrated within the submucousal layer. Five-year survival for patients without LNM was 93.9%, which was significantly higher than in patients with LNM. LNM in EGC is related to age, depth of infiltration, tumor histological type and lymphatic embolus. The survival rate with negative lymph nodes was higher than in patients with LNM. Therefore, we believe that endoscopic en bloc dissection may be considered as a surgical treatment for patients who are ≥60 years old and have a highly differentiated tumor invaded the mucous layer without lymphatic embolus. With respect to patients with high risk factors, we recommend an appropriate lymphadenectomy according to the specific situation.