Background/aims: The accurate diagnosis of lymph node metastasis is necessary in gastric cancer. This study was carried out to identify the risk factors of lymph node metastasis by extreme analysis.
Methodology: Data from 77 patients with lymph node-positive small gastric cancer and 128 patients with lymph node-negative large gastric cancer were collected. The relationship between the two groups was compared, based on the clinical, pathologic, and preoperative clinical laboratory analysis findings. The independent risk factors influencing lymph node metastasis were determined by multiple logistic regression analysis.
Results: Rural residence, introversive personality, low third gastric cancer, low serum fibrinogen content, serosal invasion, and high serum CEA level were found to be associated with lymph node metastasis. The rural residence, introversive personality, serosal invasion, and high serum CEA level were the independent risk factors for lymph node metastasis in the multivariate logistic regression model.
Conclusions: Rural residence, introversive personality, serosal invasion, and high serum CEA level were significantly and independently related to lymph node metastasis. The limited surgery with potentially incomplete lymph node dissection is not recommended in gastric cancer patients with these risk factors.