Tumor differentiation is not a risk factor for lymph node metastasis in elderly patients with early gastric cancer.

Background: The aim of this study was to identify risk factors for lymph node metastasis in elderly patients (70 years or more) with early gastric cancer.

Methods: We reviewed the prospectively collected database of 6893 patients with early gastric cancer who had undergone curative gastrectomy in 3 tertiary cancer centers between January 2003 and December 2009 in Korea. Patients were sorted into 4 groups according to age: less than 50, fifties, sixties, and 70 years or more. Risk factors for lymph node metastasis in early gastric cancer were analyzed.

Results: One thousand and thirty five patients (15.0%) were 70 years or more. As age increased, the frequency of large differentiated tumor, lymphatic and submucosa invasion increased. Old age was associated with a lower risk for lymph node metastasis in patients with early gastric cancer (Odds ratio [OR], OR, 0.622; 95% CI, 0.5466-0.830, P = 0.010). Ulceration or differentiation of tumor was not associated with lymph node metastasis in elderly patients with early gastric cancer.

Conclusions: Elderly patients with undifferentiated type histology early gastric cancer without other risk factors for lymph node metastasis may be candidates for endoscopic resection.