Characteristics of Lymph Node Metastasis in Early Gastric Cancer: a Single-center Retrospective Study.

OBJECTIVE

This study aimed to characterize lymph node metastasis(LNM) in early gastric cancer (EGC) to investigate the applicability of EGC treatment options in China, as defined in the Japanese guidelines.

METHODS

A single-center retrospective analysis was conducted using data from a high-volume tertiary hospital in Western China between 2007 and 2020 to explore LNM characteristics, risk factors, and prognosis in EGC patients who underwent gastrectomy.

RESULTS

The study enrolled 1,140 EGC cases, including 538 intramucosal(M) and 602 submucosal(SM), with 250(21.9%) experiencing LNM. For upper third EGC, lymph node(LN) stations of No.1, No.2, No.3, No.7, No.11, and No.12a showed LNM, of which the metastasis rate of No.3 exceeded 5%. The metastasis rate of No.3 exceeded 10%, and that of No.4 exceeded 5% when the primary lesion was in the middle third of the stomach. For lower third EGC, among which the metastasis rates of No.6 and No.3 exceeded 10% and that of No.4 exceeded 5%. Undifferentiation type, submucosal invasion, lymphatic-vascular invasion, and number of LNs retrieved were independent risk factors for LNM in EGC. The 5-year OS rate of EGC was 95.1% and which for N1, N2, and N3 were 94.1%, 90.2%, and 82.4%, respectively (p = 0.00038).

CONCLUSIONS

EGC patients in Western China exhibit a higher risk of LNM, regardless of the tumor's site or the presence of submucosal infiltration. The Nos. 3, 4, and 6 are the most common regional LN stations with higher rates of LNM.