Lymph node metastasis (LNM) status is an important prognostic factor that strongly influences the treatment decision of early gastric cancer (EGC). This study aimed to evaluate the pattern and clinical significance of LNM in EGC. Methods: A total of 354 patients with carcinoma in situ (n =42), EGC (n =312) who underwent radical gastrectomy were enrolled. Their clinicopathological features, pathological reports, and prognostic data were collected and analyzed. | Yanzhang et al. BMC Cancer 2021 21 1280 https s12885-021-09008-8 RESEARCH Open Access The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy a single-center retrospective study Wu Yanzhang Li Guanghua Zhou Zhihao Wang Zhixiong and Wang Zhao Abstract Background Lymph node metastasis LNM status is an important prognostic factor that strongly influences the treatment decision of early gastric cancer EGC . This study aimed to evaluate the pattern and clinical significance of LNM in EGC. Methods A total of 354 patients with carcinoma in situ n 42 EGC n 312 who underwent radical gastrec- tomy were enrolled. Their clinicopathological features pathological reports and prognostic data were collected and analyzed. Results The incidence of LNM in all patients was 65 354 . The rates of D1 and D2 station metastases were 43 354 and 22 354 respectively. The rates of LNM in absolute indication of endoscopic resection and expanded indication were 2 61 and 4 14 respectively. Skip LNM was observed in 13 354 of patients. For those with middle-third tumor the metastasis rate of the No. 5 lymph node was 5 164 . The independent risk factors for LNM were tumors measuring gt 30 mm poorly differentiated tumors and lymphovascular invasion all P 20 mm and LNM were independent predic- tive factors for poor survival outcome in all patients. Conclusions Patients with EGC conforming to expanded indications have a relatively high risk of LNM and may not be suitable for endoscopic submucosal dissection. Pylorus-preserving gastrectomy for patients with middle-third EGC remains controversial due to the high metastasis rate of the No. 5 lymph node. Keywords Lymph node metastasis Lymphatic invasion Skip metastasis Early gastric cancer Predictive model Background Gastric cancer GC is the fifth most common cancer type and the third leading cause of cancer-related .
