Lo Kuang-Hua, Huang Kuo-Hung, Fang Wen-Liang, Lin Shih-Chieh, Hung Yi-Ping, Chen Ming-Huang, Wu Chew-Wen, Kung Ching-Yun
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
World J Surg Oncol. 2025 Jul 24;23(1):301. doi: 10.1186/s12957-025-03951-7.
Lymph node dissection is a standardized procedure in gastric cancer surgery. Typically, lymph node metastasis begins in the perigastric (PG) region and then extends to the extraperigastric (EP) region. However, in some circumstances, skip lymph node metastasis occurs in the EP region without involvement of the PG lymph nodes. This study aims to investigate the clinical significance of skip lymph node metastasis in gastric cancer.
A total of 1,055 patients who underwent curative gastrectomy for primary gastric cancer with pathological lymph node metastasis were analyzed. Patients were categorized into three groups: the PG-only group, the PG + EP group, and the skip group. The clinicopathologic characteristics and prognosis were analyzed.
The incidence of skip lymph node metastasis was 3.9% (41 of 1,055 patients). The skip group had a higher proportion of females compared to both the PG-only group (43.9% vs. 27.5%, p = 0.025) and the PG + EP group (43.9% vs. 26.5%, p = 0.017). Additionally, the skip group showed a higher proportion of intestinal-type tumors compared to the PG-only group (68.3% vs. 50.6%, p = 0.029) and the PG + EP group (68.3% vs. 40.2%, p = 0.001). Disease-free survival and overall survival in the skip group were similar to those in the PG-only group but significantly better than those in the PG + EP group.
Skip lymph node metastasis is uncommon, and it is associated with a higher proportion of females and intestinal-type tumors. The prognosis of the skip group was comparable to the PG-only group and significantly better than that of the PG + EP group.
淋巴结清扫是胃癌手术中的标准化操作。通常，淋巴结转移始于胃周（PG）区域，然后扩展至胃周外（EP）区域。然而，在某些情况下，会出现胃周外区域的跳跃式淋巴结转移，而胃周淋巴结未受累。本研究旨在探讨胃癌跳跃式淋巴结转移的临床意义。
对1055例行根治性胃切除术且有病理淋巴结转移的原发性胃癌患者进行分析。患者分为三组：仅胃周组、胃周+胃周外组和跳跃组。分析其临床病理特征及预后。
跳跃式淋巴结转移的发生率为3.9%（1055例患者中的41例）。与仅胃周组（43.9%对27.5%，p = 0.025）和胃周+胃周外组（43.9%对26.5%，p = 0.017）相比，跳跃组女性比例更高。此外，与仅胃周组（68.3%对50.6%，p = 0.029）和胃周+胃周外组（68.3%对40.2%，p = 0.001）相比，跳跃组肠型肿瘤比例更高。跳跃组的无病生存期和总生存期与仅胃周组相似，但显著优于胃周+胃周外组。
跳跃式淋巴结转移并不常见，且与女性及肠型肿瘤比例较高有关。跳跃组的预后与仅胃周组相当，且显著优于胃周+胃周外组。
