Skip lymph node metastasis in gastric cancer

is it skipping or skipped?

Yoon Young Choi, Ji Yeong An, Ali Guner, Dae Ryong Kang, In Cho, In Gyu Kwon, Hyun Beak Shin, WooJin Hyung, Sung Hoon Noh

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Skip metastasis is the presence of a metastatic lymph node (LN) in an extraperigastric (EP) area without perigastric (PG) involvement. The mechanism and prognosis of skip metastasis are still unknown. The purpose of this study was to scrutinize the clinical significance of skip metastasis in gastric cancer. Methods: Data were reviewed from 6,025 patients who had undergone gastrectomy for primary gastric cancer. Patients were categorized as a PG-only group when the metastatic LNs were limited to only the PG area, as a PG + EP group if metastatic LNs extended to both the PG area and the EP area, and as a skip group if metastatic LNs were in the EP area but there were no metastatic LNs in the PG area. Results: After we had performed matching, the prognosis of the skip group was worse than that of the PG-only group (adjusted hazard ratio 1.69, 95 % confidence interval 1.13–2.54) and was similar to that of the PG + EP group (adjusted hazard ratio: 1.54, 95 % confidence interval 0.92–2.59). The number of retrieved LNs was less in the skip group than in the other groups, especially from the PG area (p < 0.001). Conclusions: The prognosis of the skip group was worse than that of the PG-only group and was similar to that of the PG + EP group when the tumor stage was considered. It is difficult to conclude whether skip metastasis is real skipping of cancer cells or a result of inadequate LN sampling. Further evaluation of LNs in the PG area of the skip group could provide more clues for the mechanism of skip metastasis.

Original languageEnglish
Pages (from-to)206-215
Number of pages10
JournalGastric Cancer
Volume19
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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Stomach Neoplasms
Lymph Nodes
Neoplasm Metastasis
Confidence Intervals
Gastrectomy
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Choi, Y. Y., An, J. Y., Guner, A., Kang, D. R., Cho, I., Kwon, I. G., ... Noh, S. H. (2016). Skip lymph node metastasis in gastric cancer: is it skipping or skipped? Gastric Cancer, 19(1), 206-215. https://doi.org/10.1007/s10120-015-0472-5
Choi, Yoon Young ; An, Ji Yeong ; Guner, Ali ; Kang, Dae Ryong ; Cho, In ; Kwon, In Gyu ; Shin, Hyun Beak ; Hyung, WooJin ; Noh, Sung Hoon. / Skip lymph node metastasis in gastric cancer : is it skipping or skipped?. In: Gastric Cancer. 2016 ; Vol. 19, No. 1. pp. 206-215.
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abstract = "Background: Skip metastasis is the presence of a metastatic lymph node (LN) in an extraperigastric (EP) area without perigastric (PG) involvement. The mechanism and prognosis of skip metastasis are still unknown. The purpose of this study was to scrutinize the clinical significance of skip metastasis in gastric cancer. Methods: Data were reviewed from 6,025 patients who had undergone gastrectomy for primary gastric cancer. Patients were categorized as a PG-only group when the metastatic LNs were limited to only the PG area, as a PG + EP group if metastatic LNs extended to both the PG area and the EP area, and as a skip group if metastatic LNs were in the EP area but there were no metastatic LNs in the PG area. Results: After we had performed matching, the prognosis of the skip group was worse than that of the PG-only group (adjusted hazard ratio 1.69, 95 {\%} confidence interval 1.13–2.54) and was similar to that of the PG + EP group (adjusted hazard ratio: 1.54, 95 {\%} confidence interval 0.92–2.59). The number of retrieved LNs was less in the skip group than in the other groups, especially from the PG area (p < 0.001). Conclusions: The prognosis of the skip group was worse than that of the PG-only group and was similar to that of the PG + EP group when the tumor stage was considered. It is difficult to conclude whether skip metastasis is real skipping of cancer cells or a result of inadequate LN sampling. Further evaluation of LNs in the PG area of the skip group could provide more clues for the mechanism of skip metastasis.",
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Choi, YY, An, JY, Guner, A, Kang, DR, Cho, I, Kwon, IG, Shin, HB, Hyung, W & Noh, SH 2016, 'Skip lymph node metastasis in gastric cancer: is it skipping or skipped?', Gastric Cancer, vol. 19, no. 1, pp. 206-215. https://doi.org/10.1007/s10120-015-0472-5

Skip lymph node metastasis in gastric cancer : is it skipping or skipped? / Choi, Yoon Young; An, Ji Yeong; Guner, Ali; Kang, Dae Ryong; Cho, In; Kwon, In Gyu; Shin, Hyun Beak; Hyung, WooJin; Noh, Sung Hoon.

In: Gastric Cancer, Vol. 19, No. 1, 01.01.2016, p. 206-215.

Research output: Contribution to journalArticle

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T1 - Skip lymph node metastasis in gastric cancer

T2 - is it skipping or skipped?

AU - Choi, Yoon Young

AU - An, Ji Yeong

AU - Guner, Ali

AU - Kang, Dae Ryong

AU - Cho, In

AU - Kwon, In Gyu

AU - Shin, Hyun Beak

AU - Hyung, WooJin

AU - Noh, Sung Hoon

PY - 2016/1/1

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N2 - Background: Skip metastasis is the presence of a metastatic lymph node (LN) in an extraperigastric (EP) area without perigastric (PG) involvement. The mechanism and prognosis of skip metastasis are still unknown. The purpose of this study was to scrutinize the clinical significance of skip metastasis in gastric cancer. Methods: Data were reviewed from 6,025 patients who had undergone gastrectomy for primary gastric cancer. Patients were categorized as a PG-only group when the metastatic LNs were limited to only the PG area, as a PG + EP group if metastatic LNs extended to both the PG area and the EP area, and as a skip group if metastatic LNs were in the EP area but there were no metastatic LNs in the PG area. Results: After we had performed matching, the prognosis of the skip group was worse than that of the PG-only group (adjusted hazard ratio 1.69, 95 % confidence interval 1.13–2.54) and was similar to that of the PG + EP group (adjusted hazard ratio: 1.54, 95 % confidence interval 0.92–2.59). The number of retrieved LNs was less in the skip group than in the other groups, especially from the PG area (p < 0.001). Conclusions: The prognosis of the skip group was worse than that of the PG-only group and was similar to that of the PG + EP group when the tumor stage was considered. It is difficult to conclude whether skip metastasis is real skipping of cancer cells or a result of inadequate LN sampling. Further evaluation of LNs in the PG area of the skip group could provide more clues for the mechanism of skip metastasis.

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Choi YY, An JY, Guner A, Kang DR, Cho I, Kwon IG et al. Skip lymph node metastasis in gastric cancer: is it skipping or skipped? Gastric Cancer. 2016 Jan 1;19(1):206-215. https://doi.org/10.1007/s10120-015-0472-5