Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Association between Lymphovascular Invasion and Recurrence in Patients with pT1N+ or pT2-3N0 Gastric Cancer: a Multi-institutional Dataset Analysis

  • Fujita, Keizo (Department of Surgery, Ichinomiya Municipal Hospital) ;
  • Kanda, Mitsuro (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Ito, Seiji (Department of Gastroenterological Surgery, Aichi Cancer Center) ;
  • Mochizuki, Yoshinari (Department of Surgery, Komaki Municipal Hospital) ;
  • Teramoto, Hitoshi (Department of Surgery, Yokkaichi Municipal Hospital) ;
  • Ishigure, Kiyoshi (Department of Surgery, Konan Kosei Hospital) ;
  • Murai, Toshifumi (Department of Surgery, Ichinomiya Municipal Hospital) ;
  • Asada, Takahiro (Department of Surgery, Gifu Prefectural Tajimi Hospital) ;
  • Ishiyama, Akiharu (Department of Surgery, Okazaki City Hospital) ;
  • Matsushita, Hidenobu (Department of Surgery, Tosei General Hospital) ;
  • Tanaka, Chie (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Kobayashi, Daisuke (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Fujiwara, Michitaka (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine) ;
  • Murotani, Kenta (Biostatistics Center, Graduate School of Medicine, Kurume University) ;
  • Kodera, Yasuhiro (Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine)
  • Received : 2019.09.18
  • Accepted : 2019.12.16
  • Published : 2020.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Patients with pathological stage T1N+ or T2-3N0 gastric cancer may experience disease recurrence following curative gastrectomy. However, the current Japanese Gastric Cancer Treatment Guidelines do not recommend postoperative adjuvant chemotherapy for such patients. This study aimed to identify the prognostic factors for patients with pT1N+ or pT2-3N0 gastric cancer using a multi-institutional dataset. Materials and Methods: We retrospectively analyzed the data obtained from 401 patients with pT1N+ or pT2-3N0 gastric cancer who underwent curative gastrectomy at 9 institutions between 2010 and 2014. Results: Of the 401 patients assessed, 24 (6.0%) experienced postoperative disease recurrence. Multivariate analysis revealed that age ≥70 years (hazard ratio [HR], 2.62; 95% confidence interval [CI], 1.09-7.23; P=0.030) and lymphatic and/or venous invasion (lymphovascular invasion (LVI): HR, 7.88; 95% CI, 1.66-140.9; P=0.005) were independent prognostic factors for poor recurrence-free survival. There was no significant association between LVI and the site of initial recurrence. Conclusions: LVI is an indicator of poor prognosis in patients with pT1N+ or pT2-3N0 gastric cancer.

Keywords

References

  1. Van Cutsem E, Sagaert X, Topal B, Haustermans K, Prenen H. Gastric cancer. Lancet 2016;388:2654-2664. https://doi.org/10.1016/S0140-6736(16)30354-3
  2. Shum H, Rajdev L. Multimodality management of resectable gastric cancer: a review. World J Gastrointest Oncol 2014;6:393-402. https://doi.org/10.4251/wjgo.v6.i10.393
  3. Kanda M, Murotani K, Kobayashi D, Tanaka C, Yamada S, Fujii T, et al. Postoperative adjuvant chemotherapy with S-1 alters recurrence patterns and prognostic factors among patients with stage II/III gastric cancer: a propensity score matching analysis. Surgery 2015;158:1573-1580. https://doi.org/10.1016/j.surg.2015.05.017
  4. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer 2017;20:1-19. https://doi.org/10.1007/s10120-016-0622-4
  5. Shen L, Shan YS, Hu HM, Price TJ, Sirohi B, Yeh KH, et al. Management of gastric cancer in Asia: resource-stratified guidelines. Lancet Oncol 2013;14:e535-e547. https://doi.org/10.1016/S1470-2045(13)70436-4
  6. Katai H, Ishikawa T, Akazawa K, Isobe Y, Miyashiro I, Oda I, et al. Five-year survival analysis of surgically resected gastric cancer cases in Japan: a retrospective analysis of more than 100,000 patients from the nationwide registry of the Japanese Gastric Cancer Association (2001-2007). Gastric Cancer 2018;21:144-154. https://doi.org/10.1007/s10120-017-0716-7
  7. Kanda M, Ito S, Mochizuki Y, Teramoto H, Ishigure K, Murai T, et al. Multi-institutional analysis of the prognostic significance of postoperative complications after curative resection for gastric cancer. Cancer Med 2019;8:5194-5201. https://doi.org/10.1002/cam4.2439
  8. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101-112. https://doi.org/10.1007/s10120-011-0041-5
  9. Liu JY, Peng CW, Yang XJ, Huang CQ, Li Y. The prognosis role of AJCC/UICC 8th edition staging system in gastric cancer, a retrospective analysis. Am J Transl Res 2018;10:292-303.
  10. Kanda M, Mizuno A, Fujii T, Shimoyama Y, Yamada S, Tanaka C, et al. Tumor infiltrative pattern predicts sites of recurrence after curative gastrectomy for stages 2 and 3 gastric cancer. Ann Surg Oncol 2016;23:1934-1940. https://doi.org/10.1245/s10434-016-5102-x
  11. Tokunaga M, Ito S, Yoshikawa T, Nunobe S, Fukagawa T, Misawa K, et al. Prognostic factors for survival in patients with pT1 N+ or T2-3 N0 gastric cancer in Japan. Br J Surg 2017;104:885-890. https://doi.org/10.1002/bjs.10509
  12. Kunisaki C, Makino H, Kimura J, Takagawa R, Kosaka T, Ono HA, et al. Impact of lymphovascular invasion in patients with stage I gastric cancer. Surgery 2010;147:204-211. https://doi.org/10.1016/j.surg.2009.08.012
  13. Du CY, Chen JG, Zhou Y, Zhao GF, Fu H, Zhou XK, et al. Impact of lymphatic and/or blood vessel invasion in stage II gastric cancer. World J Gastroenterol 2012;18:3610-3616. https://doi.org/10.3748/wjg.v18.i27.3610
  14. del Casar JM, Corte MD, Alvarez A, Garcia I, Bongera M, Gonzalez LO, et al. Lymphatic and/or blood vessel invasion in gastric cancer: relationship with clinicopathological parameters, biological factors and prognostic significance. J Cancer Res Clin Oncol 2008;134:153-161. https://doi.org/10.1007/s00432-007-0264-3
  15. Dicken BJ, Graham K, Hamilton SM, Andrews S, Lai R, Listgarten J, et al. Lymphovascular invasion is associated with poor survival in gastric cancer: an application of gene-expression and tissue array techniques. Ann Surg 2006;243:64-73. https://doi.org/10.1097/01.sla.0000194087.96582.3e
  16. Lu J, Dai Y, Xie JW, Wang JB, Lin JX, Chen QY, et al. Combination of lymphovascular invasion and the AJCC TNM staging system improves prediction of prognosis in N0 stage gastric cancer: results from a high-volume institution. BMC Cancer 2019;19:216. https://doi.org/10.1186/s12885-019-5416-8
  17. Zhao B, Huang X, Zhang J, Luo R, Lu H, Xu H, et al. Clinicopathologic factors associated with recurrence and long-term survival in node-negative advanced gastric cancer patients. Rev Esp Enferm Dig 2019;111:111-120.

Cited by

  1. Update June 2020 vol.18, pp.3, 2020, https://doi.org/10.1089/lrb.2020.29087.fb
  2. Molecular classification reveals the diverse genetic and prognostic features of gastric cancer: A multi-omics consensus ensemble clustering vol.144, 2020, https://doi.org/10.1016/j.biopha.2021.112222