Predictable factors for lymph node metastasis in early gastric cancer-analysis of single institutional experience

J Gastrointest Surg. 2011 Oct;15(10):1783-8. doi: 10.1007/s11605-011-1624-5. Epub 2011 Jul 28.


Introduction: Prediction of lymph node metastasis in early gastric cancer (EGC) is very important to decide treatment strategies preoperatively. The aim of this study was to evaluate factors that predict the presence of lymph node metastasis and to identify the differences between mucosal and submucosal gastric cancers.

Methods: A total of 376 patients with EGC who underwent gastrectomy from March 1999 through December 2007 were retrospectively identified. The clinopathological factors and biological markers (p53, Ki67) were analyzed.

Results: The rate of lymph node metastasis was 9.6% (mucosal cancer 2.8%, submucosal cancer 18.4%). Tumor size, depth of invasion, macroscopic type, and lymphovascular invasion were related to lymph node metastasis in EGC. When the carcinomas were confined to the mucosal layer, tumor size and lymphovascular invasion showed significant correlation with lymph node metastasis. On the other side, macroscopic type and lymphovascular invasion were association with lymph node metastasis in submucosal carcinoma.

Conclusion: The risk factors for lymph node metastasis in EGC are quite different depending on depth of tumor invasion. To predict lymph node metastasis in EGC, it is recommended that distinct assessment according to individual situation should be clearly established.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / metabolism
  • Carcinoma / secondary*
  • Carcinoma / therapy
  • Female
  • Gastric Mucosa / pathology
  • Humans
  • Ki-67 Antigen / metabolism
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms / metabolism
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / therapy
  • Tumor Suppressor Protein p53 / metabolism


  • Ki-67 Antigen
  • Tumor Suppressor Protein p53