Prognostic significance of lymphovascular invasion in pN0 stage gastric cancer: a propensity score matching analysis

To explore the potential impact of lymphovascular invasion (LVI) on overall survival (OS) of pN0 stage gastric cancer (GC) after curative resection.

A total of 497 GC patients who underwent curative gastrectomy and postoperative pathology proved negative lymph node metastasis between January 2015 and December 2018 in our center were enrolled in this study. All patients were divided into two groups according to the status of LVI. Their clinical and pathological features were compared and potential prognostic factors were analyzed using the propensity score matching analysis (PSM).

Ninety-nine (19.9%) patients had LVI. The presence of LVI was associated with significantly worse survival outcomes in both the overall and PSM cohorts (χ2 = 19.635, p < 0.001; χ2 = 9.367, p = 0.002). After PSM, data of 99 pairs of patients were extracted. Multivariate analysis revealed that number of examined lymph nodes (LNs), and LVI were independent predictors of OS (all p < 0.05). Following stratified analysis, patients with LNs 11–25 and those without LVI tended to have better OS than those with LVI (LNs 11–15: χ2 = 5.019, p = 0.025; LNs 16–25: χ2 = 11.876, p = 0.001).

pN0 stage GC patients with LVI have poor prognosis. More than 15 lymph nodes need to be dissected to reduce the influence of LVI on the prognosis of pN0 stage GC patients.