Prognostic impact of venous invasion in stage IB node-negative gastric cancer

Abstract

Background Little is known about risk factors for recurrence in stage IB gastric cancer without lymph node metastasis. The aims of this study were to determine prognostic factors associated with long-term survival and to clarify patterns of recurrence. Methods We retrospectively reviewed the medical records of 130 patients with primary gastric cancer who underwent gastrectomy at Kitasato University East Hospital from 2001 through 2010 and analyzed clinicopathological characteristics associated with survival and patterns of recurrence. Results Of the 130 patients, 12 (9.2 %) had recurrence, among whom 10 (83 %) patients died. Four patients (3.1 %) died of other diseases. The 5-year overall survival rate was 89 %. Of the 12 patients with recurrence, 7 (58 %) had liver metastasis, 3 (25 %) had distant lymph-node metastasis, 2 (17 %) had peritoneal dissemination, and 1 (8.3 %) had locoregional recurrence. Patients with tumors more than 5 cm in diameter tended to have recurrence within 1 year. Patients who had recurrence more than 2 years after surgery tended to survive for longer than 5 years after recurrence. Moderate or marked venous invasion (v2 or v3) and age [65 years were significantly associated with relapse-free and overall survival on univariate analysis. On multivariate analysis, the only independent prognostic factor for relapse-free and overall survival was venous invasion. Conclusions Moderate or marked venous invasion (v2 or v3) is an independent predictor of relapse-free and overall survival in stage IB node-negative gastric cancer. Postoperative adjuvant chemotherapy, currently not given to this subgroup of patients, may improve the outcomes of patients with stage IB node-negative gastric cancer, particularly when accompanied by venous invasion.

Optimal treatment for Siewert type II and III adenocarcinoma of the esophagogastric junction: A retrospective cohort study with long-term follow-up

“…Because both v2 or v3 and LNR of > 0.16 cannot be diagnosed preoperatively, postoperative adjuvant chemotherapy would likely improve prognoses of such high-risk patients. Either v2 or v3 is reportedly an independent prognostic factor for Stage IB node-negative gastric cancer[25]. Venous invasion theoretically predicts hematological metastases, and lymphatic invasion, LN metastases.…”

Prognostic Impact of Splenectomy in Patients with Esophagogastric Junction Carcinoma

“…Several previous studies have identified a number of prognostic factors for gastric cancer, with lymph node metastasis being the strongest prognostic factor after curative resection (5), and venous invasion only reported as an unfavourable prognostic factor in patients with IB stage gastric cancer without lymph node metastasis (12). ECJ carcinoma patients with venous invasion may thus have a poor prognosis compared with gastric cancer, and may benefit from the effective use of adjuvant chemotherapy.…”

Predictive factors for lymph node metastasis in additional gastrectomy after endoscopic resection of cT1aN0 gastric cancer

“…Submucosal invasion was subdivided into SM1 (tumor invasion less than 500 μm from the muscularis mucosa) or SM2 (tumor invasion more than 500 μm from the muscularis mucosa). The subdivision of venous invasion (v0, v1, v2, and v3) was also conducted using a similar manner [25]. Venous invasion was determined by Elastica van Gieson staining.…”