Prognostic Factor in Early Gastric Cancer

Lee, Seung Hwan; Kim, Hyung Rok; Kim, Dong Yi; Kim, Young Jin; Kim, Shin Kon

Abstract

PURPOSE
In advanced gastric cancer, the important prognostic factors are depth of invasion and status of lymph node metastasis, etc. In early gastric cancer, it remains controversial that depth of invasion or lymph node metastasis is corelated to the prognosis. A retrospective analysis of early gastric cancer was performed to evaluate the clinicopathologic features and to know the factors affecting the prognosis.
MATERIALS AND METHODS
From January 1981 to May 1997, we experienced 1850 cases of gastric cancer who performed gastric resections. Among them, 371 cases were early gastric cancer (20.1% of all resected gastric cancer cases). We defined 12 variable factors such as sex, age, tumor location, gross type, histologic type, depth of invasion, status of lymph node metastasis, tumor size, DNA ploidy pattem, stage, operation type, and resection type for prognostic factor and analyzed them.
RESULTS
Overall five year survival rate was 89.6% and ten year survival rate was 82.0%. The trend of annual incidence in recent nine years showed steady increase from 13.1% in 1988 to 25.7% in 1996. Survival showed no significant correlation with sex, age, tumor location, gross type, histologic type, tumor size, DNA ploidy, resection type. According to univariate analysis, depth of invasion, lymph node metastasis, stage had statistically significant association with prognosis. Among them, lymph node metastasis had an inde- pendent and predominant impact on survival according to multivariate analysis.
CONCLUSION
Early gastric cancer appears to show steady increase of annual incidence, and lymph node metastasis appears to be closely related to the prognosis.