J Gastric Cancer.  2020 Mar;20(1):41-49. 10.5230/jgc.2020.20.e3.

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

  • 1Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan. innocentworld0hinata@yahoo.co.jp
  • 2Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.
  • 3Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan.
  • 4Department of Surgery, Komaki Municipal Hospital, Komaki, Japan.
  • 5Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan.
  • 6Department of Surgery, Konan Kosei Hospital, Konan, Japan.
  • 7Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.
  • 8Department of Surgery, Okazaki City Hospital, Okazaki, Japan.
  • 9Department of Surgery, Tosei General Hospital, Seto, Japan.
  • 10Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Japan.


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.
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.
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.
LVI is an indicator of poor prognosis in patients with pT1N+ or pT2-3N0 gastric cancer.


Gastric cancer; Recurrence; Risk factor
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