Effect of vascular infiltration on the prognosis of patients after radical resection in early gastric cancer / 中华普通外科杂志

ABSTRACT

Objective:To evaluate the effect of vascular infiltration on the prognosis of patients with early gastric cancer.Methods:A retrospective study was performed on 625 pathologically confirmed early gastric cancer patients at the Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital from Jan 2005 to Jan 2014. χ 2 test was used to analyze the relationship between vascular invasion and clinicopathological characteristics; COX proportional hazards model was used to analyze the effect of vascular invasion on the prognosis of patients with early gastric cancer; Kaplan-Meier method was used for survival analysis. Results:There were 625 patients, including 240 (38.4%) in T1a stage and 385(61.6%) in T1b stage. 59 patients (9.4%) had vascular infiltration. Vascular invasion was related to age (χ 2=12.143, P<0.001), depth of tumor invasion (χ 2=27.538, P<0.001) and lymph node metastasis (χ 2=86.846, P<0.001). Multivariate analysis showed that age ( HR=4.370, P<0.001), positive lymph node metastasis ( HR=2.500, P<0.001) and vascular invasion ( HR=2.356, P=0.007) are independent factors affecting the prognosis. The overall 5-year survival rate for the entire group was 84.6%, that without vascular infiltration was 86.0%, significantly higher than 71.2% of those with vascular infiltration ( P=0.001). Conclusion:Age, tumor invasion depth and lymph node metastasis are risk factors for vascular invasion which in early gastric cancer predicts poor prognosis.