Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer

BackgroundLymph node (LN) status is an independent factor affecting the prognosis of gastric cancer patients. Skip metastasis is a pattern of LN metastasis across a peritumoral (PT) area to an extra-peritumoral (EP) area. The purpose of the present study was to determine the clinical characteristics...

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Main Authors: Xinwei Zhang, Yuwei Du, Yuegang Li, Chi Xue, Zhi Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1590133/full
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author Xinwei Zhang
Yuwei Du
Yuegang Li
Chi Xue
Zhi Zhu
author_facet Xinwei Zhang
Yuwei Du
Yuegang Li
Chi Xue
Zhi Zhu
author_sort Xinwei Zhang
collection DOAJ
description BackgroundLymph node (LN) status is an independent factor affecting the prognosis of gastric cancer patients. Skip metastasis is a pattern of LN metastasis across a peritumoral (PT) area to an extra-peritumoral (EP) area. The purpose of the present study was to determine the clinical characteristics and establish a predictive nomogram for skip metastasis in gastric cancer.MethodsWe reviewed the records of 1657 gastric cancer patients at the First Affiliated Hospital of China Medical University. The patients were categorized in four groups: only station II (skip group); only station I (PT-only group); station I and station II (PT+EP group); and no metastatic LNs (N0 group). The clinical characteristics between the skip group and the other three groups were compared.ResultsThe incidence of skip metastasis was 3.3% (55/1657) among the gastric cancer patients. The most common locations of skip metastasis were the No. 7 (50.9%), No. 8a (32.7%), No. 9 (21.8%), and No. 1 groups (20.0%). The skip group had significant differences compared to the PT+EP group in pN stage, Borrmann type, pT stage and location, as predictors in the nomogram for prediction of skip metastasis. The area under the ROC curve was 0.908.ConclusionsThis study identified key risk factors for skip lymph node metastasis and developed the first clinically applicable predictive model. The resulting nomogram demonstrated high accuracy in risk stratification, providing a visual tool to optimize lymph node dissection strategies. These findings support incorporating metastatic location into gastric cancer staging systems and the location of LN metastasis should be considered to improve the LN staging.
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spelling doaj-art-dc63a4e433184f4592b7a0ddafe41f652025-08-20T03:03:50ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.15901331590133Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancerXinwei ZhangYuwei DuYuegang LiChi XueZhi ZhuBackgroundLymph node (LN) status is an independent factor affecting the prognosis of gastric cancer patients. Skip metastasis is a pattern of LN metastasis across a peritumoral (PT) area to an extra-peritumoral (EP) area. The purpose of the present study was to determine the clinical characteristics and establish a predictive nomogram for skip metastasis in gastric cancer.MethodsWe reviewed the records of 1657 gastric cancer patients at the First Affiliated Hospital of China Medical University. The patients were categorized in four groups: only station II (skip group); only station I (PT-only group); station I and station II (PT+EP group); and no metastatic LNs (N0 group). The clinical characteristics between the skip group and the other three groups were compared.ResultsThe incidence of skip metastasis was 3.3% (55/1657) among the gastric cancer patients. The most common locations of skip metastasis were the No. 7 (50.9%), No. 8a (32.7%), No. 9 (21.8%), and No. 1 groups (20.0%). The skip group had significant differences compared to the PT+EP group in pN stage, Borrmann type, pT stage and location, as predictors in the nomogram for prediction of skip metastasis. The area under the ROC curve was 0.908.ConclusionsThis study identified key risk factors for skip lymph node metastasis and developed the first clinically applicable predictive model. The resulting nomogram demonstrated high accuracy in risk stratification, providing a visual tool to optimize lymph node dissection strategies. These findings support incorporating metastatic location into gastric cancer staging systems and the location of LN metastasis should be considered to improve the LN staging.https://www.frontiersin.org/articles/10.3389/fonc.2025.1590133/fullgastric cancerskip metastasisnomogramclinicopathological featuresprognosis
spellingShingle Xinwei Zhang
Yuwei Du
Yuegang Li
Chi Xue
Zhi Zhu
Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer
Frontiers in Oncology
gastric cancer
skip metastasis
nomogram
clinicopathological features
prognosis
title Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer
title_full Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer
title_fullStr Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer
title_full_unstemmed Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer
title_short Clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer
title_sort clinicopathologic characteristics and predictive nomogram of skip lymph node metastasis in gastric cancer
topic gastric cancer
skip metastasis
nomogram
clinicopathological features
prognosis
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1590133/full
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AT yuegangli clinicopathologiccharacteristicsandpredictivenomogramofskiplymphnodemetastasisingastriccancer
AT chixue clinicopathologiccharacteristicsandpredictivenomogramofskiplymphnodemetastasisingastriccancer
AT zhizhu clinicopathologiccharacteristicsandpredictivenomogramofskiplymphnodemetastasisingastriccancer