Correlation between subserosal venous invasion by gastric cancer and the occurrence of liver metastasis.

We have examined the correlation between the depth of venous invasion of the gastric wall and the occurrence of liver metastasis in cases of gastric cancer. In 244 patients examined, the incidence of venous invasion, and in particular of subserosal venous invasion, was appreciably high in cases of poorly differentiated adenocarcinoma of the medullary type. Synchronous and metachronous liver metastases were found in 13 and 18 patients, respectively. In these cases, poorly differentiated adenocarcinoma with a medullary growth pattern was the most frequent, and papillary adenocarcinoma was the next most frequent type of cancer. The incidence of liver metastases was appreciably higher in patients with subserosal venous invasion than in those with only submucosal venous invasion. Considering the above observations, we posit that subserosal venous invasion by cancer, especially by poorly differentiated adenocarcinoma of the medullary type, is indicative of the risk for development of liver metastasis in patients with gastric cancer.