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Role of Assessment for Venous Invasion in Predicting Prognosis After Surgical Treatment of Gastric Cancer
Yuta Ibuki*, Hiroki Kitagawa, Akira Nakashima
Department of Surgery, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
Background: Venous invasion (VI) is reportedly associated with a lymph node metastasis for patients with early gastric cancer. However, the impact of venous invasion levels on the prognosis of patients with advanced gastric cancer remains unknown. The aim of present study is to determine the prognostic significance of venous invasion levels on the survival of patients with advanced gastric cancer.
Method: We reviewed the records of consecutive 291 patients with advanced gastric cancer who underwent complete resection. We assessed VI levels on resected specimen as well as depths of tumor (T), Lymph node metastasis (N), lymphatic invasion (LI), infiltration type (INF), and tumor differentiation. The relationships between these pathological findings and survival were evaluated.
Result: The findings of univariate Cox regression analyses suggested that T factor(HR, 3.933; p < 0.001), N factor(HR, 3.933; p < 0.001), LI level(HR, 3.933; p < 0.001), and VI level(HR, 3.933; p < 0.001) were significant predictor of overall survival. Multivariate analysis showed that N factor (HR, 3.933; p < 0.001) and VI level (HR, 2.484; p < 0.001) were independent predictors.
VI levels could also stratified survival in patients with node positive patients (N=192, p < 0.001).
VI level showed significant relationship to distant relapses, but it did not show significant relationship to locoregional relapses.
Conclusion: VI level could predict the prognosis of patients with advanced gastric cancer. The relationship between VI levels and distant relapse seems to affect survival.
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