Carcinomatous lymphatic invasion in early gastric cancer invading into thesubmucosa

Background: Lymphatic invasion is a risk factor for lymph node metastases i n patients with gastric cancer. No studies have been reported, however, on the correlation between lymphatic invasion and lymph node metastasis in ear ly gastric cancer invading into the submucosa. Methods: We performed a retrospective analysis of lymphatic invasion in 170 patients with early gastric cancer invading into the submucosa. Results: Lymphatic invasion was found in 76 patients. Lymphatic invasion co rrelated significantly with the presence of lymph node metastasis and vascu lar invasion (P < .05) and with the degree of cancerous submucosal involvem ent (P < .05). The presence of lymph node metastasis also correlated with t he grade of submucosal invasion and lymphatic invasion. The 5-year survival of patients with lymphatic invasion was poorer than that of patients witho ut lymphatic invasion (P < .05). Node-negative patients had similar surviva l, regardless of the presence of lymphatic invasion. All patients with seve re lymphatic invasion had sm3 invasion and lymph node metastases. Conclusion: Although lymphatic invasion is the first stage of lymph node me tastasis, lymphatic invasion in itself does not have clinical importance ex cept for severe invasion in early gastric cancer. It is possible to predict lymph node metastases from the combined evaluation of degree of lymphatic invasion and submucosal involvement of the tumor in patients with early gas tric cancer invading into the submucosa.