Clinicopathological Characteristics Associated with Lymph Node Metastasis in Early Gastric Cancer with Submucosal Invasion SHEN Li-zong, HUANG Yi-ming, SUN Mao-cai, et al. Department of General Surgery, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China Corresponind author: SHEN Li-zong, E-mail: shenlz@163.com Abstract Objective To investigate the clinicopathological characteristics of early gastric cancer with submucoal invasion associated with lymph node metastasis. Methods The data from 181 patients surgically treated for early gastric cancer with submucosal invasion between 1998 and 2007 were reviewed retrospectively. The clinicopathological variables associated with lymph node metastasis were evaluated. Results Lymph node metastasis was observed in 20.44% of patients. The histological classification, tumor size, location in the stomach and presence of vascular or lymphatic invasion showed a positive correlation with the rate of lymph node metastasis by univariate analysis. Multivariate analyses revealed histological classification and tumor size to be significantly and independently related to lymph node metastasis. Conclusion Histological classification, tumor size, location in the stomach and presence of vascular or lymphatic invasion are risk factors for lymph node metastasis in early gastric cancer with submucoal invasion. Minimal invasive treatment, such as endoscopic submucosal dissection, may be possible in highly selective cancers.