The Clinical Significance of Lymphovascular Invasion in Gastric Cancer

Abstract

Background/aim: Lymphovascular invasion (LVI) is recognized as a prognostic predictor of recurrence in certain carcinomas. According to current Japanese guidelines, however, in gastric cancer, LVI is not clinically useful information, except for predicting the curability of endoscopic resection. We clarified the clinical significance of LVI in gastric cancer and its correlation with disease prognosis.

Patients and methods: A total of 2,090 cases of gastric cancer undergoing radical gastrectomy were enrolled. The correlation of LVI and other histopathological factors was evaluated with regards to patient prognosis.

Results: LVI(+) was noted in 894 cases. A multivariate analysis showed that pT, pN, and LVI were independent risk factors for patient prognosis. In pT2-4 patients with nodal metastasis, a significant difference was revealed, and the 5-year overall survival rates in LVI(+) cases were lower than those in LVI(-) (60.9% vs. 76.7%, p=0.005).

Conclusion: LVI in gastric cancer is an independent prognostic factor, and tends to worsen prognosis, especially in advanced cancers with lymph node metastases.

Keywords: Gastric cancer; lymphovascular invasion; prognostic factor.

Figure 1. Impact of lymphovascular invasion (LVI) on the prognosis of patients with gastric cancer. (A) Log-rank test for all 2,090 patients; (B) Log-rank test for early gastric cancer patients (T1); (C) Log-rank test for advance gastric cancer (T2-4)

Figure 2. Prognostic significance of lymphovascular invasion (LVI) in patients stratified by each T-factor and N-factor. (A) Log-rank test for T1 N-; (B) Log-rank test for T1 N+; (C) Log-rank test for T2-4 N-; (D) Log-rank test for T2-4 N+