SURGICAL OUTCOME IN EARLY GASTRIC-CANCER WITH LYMPH-NODE METASTASIS

Background/Aims: Definitive surgical management of early gastric cance r with lymph node metastasis has not been established. This paper desc ribes the clinico-pathologic characteristics of early gastric cancer w ith lymph node metastasis. Materials and Methods: A retrospective stud y of early gastric cancer with lymph node metastasis (32 patients) was performed to compare clinico-pathologic features with patients withou t lymph node metastasis (283 patients). Results: All patients with lym ph node metastasis had submucosal gastric invasion. The incidence of h istologically proven. curative resection in patients with lymph node m etastasis was significantly lower than in those without metastasis (40 .6 % versus 93.3 %). The 5-year survival rate was poorer in patients w ith positive nodes than in those with negative nodes (83.8 % versus 96 .2 %). Recurrence was more frequent in patients with involved nodes (1 2.5 % versus 0.4 %). Lymph node metastasis was more frequent with the following: submucosal invasion, tumor over 5 cm in size, positive veno us involvement, and an advanced growth pattern. Conclusions: Pre-opera tive and intra-operative evaluation for lymph node metastasis is essen tial for the appropriate surgical treatment of early gastric cancer.