Clinicopathologic Study on the Significance of Intramural Lymphatic Invasion of Cancer Cells in Gastric Cancer

Abstract

Lymphatic invasion of cancer cells is frequently mentioned in pathology reports of gastric cancer, however its clinical significance is controversial. We investigated the followings A prospective analysis of te various clinicopatholgic factors including lymphatic invasion was done after topographic reconstruction of 477 resected gastreic cancer specimens at the National Medical center form 1987 to 1991. Lymphatic invasion was found in 119 cases(24.9%) and we analysed its relation to various clinicopatholgic factors: i.e. stage, depth, lymph node metastasis, size, gross and microscopic types of tumor. We also analysed its influence on survival of serosa negative, lymph node negative cases, and then resection margins. Its positive rate was significantly higher in stage 3cases, T3 cases of primary tumor and cases of lymph node metastasis. The rate of lymphatic invasion was high in infiltrative gross type and undifferentiated histologic type, therewas no significant survival rate difference be tween positive lymphatic invasion and negative in the serosa negative and lymph node negative cases. However lymphatic invasion significantly influenced 5 year survival sate of stage 3 curative resection cases. The maximum distance of lymphatic invasion from the tumor was 8.5cm in proximal side and 5.6cm in distal side. While distance was related to the progress of tumor, however it was impossible to quantify due to palliative resection cases which is done in many of lymphatic invasion cases(26.1%). Lymphatic invasion also influenced 53.8% of the proximal rescction margin positive cases and 48% of the distal resection margin positive cases, especially in the advaned disease.