Lymph node micrometastases in early gastric carcinoma alone inadequately reflect the new model of metastatic development.

Forty early gastric carcinomas were studied retrospectively for the presence of micrometastases in the regional lymph nodes by cytokeratin 18 immunostaining. Tumor typing, grading and staging were reestimated and ploidy of the tumors was assessed with the CAS 200. Micrometastases were found only in 3 cases, while macrometastases were present in 6 cases (micrometastases were present in 3 of those 6 patients). Micrometastases had no effect on patients' survival. It has been concluded that in early gastric carcinoma micrometastases do not influence typing, grading, staging of the tumor and have no prognostic significance. It has also been concluded that it takes more than the diagnosis of micrometastasis alone to estimate its real prognostic significance, especially in view of the new by emerging concept of cancer metastatic development.