Regmi P, Regmi SM, Paudyal A. Importance of the pattern of lymph node metastasis in upper and lower gastric cancer. World J Gastrointest Oncol 2025; 17(9): 103144 [DOI: 10.4251/wjgo.v17.i9.103144]
Corresponding Author of This Article
Parbatraj Regmi, MD, PhD, Lecturer, Department of Surgery, BP Koirala Institute of Health Sciences, Dharan-18, Dharan 56700, Nepal. regmipar@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Sep 15, 2025; 17(9): 103144 Published online Sep 15, 2025. doi: 10.4251/wjgo.v17.i9.103144
Importance of the pattern of lymph node metastasis in upper and lower gastric cancer
Parbatraj Regmi, Sagar Mani Regmi, Anish Paudyal
Parbatraj Regmi, Sagar Mani Regmi, Department of Surgery, BP Koirala Institute of Health Sciences, Dharan 56700, Nepal
Anish Paudyal, Department of Surgery, Nepal Medical College, Kathmandu 44600, Nepal
Author contributions: Regmi P wrote the original draft and contributed to conceptualization, writing, reviewing, and editing; Regmi SM and Paudyal A participated in reviewing and editing the manuscript; and all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Parbatraj Regmi, MD, PhD, Lecturer, Department of Surgery, BP Koirala Institute of Health Sciences, Dharan-18, Dharan 56700, Nepal. regmipar@gmail.com
Received: November 11, 2024 Revised: March 22, 2025 Accepted: April 10, 2025 Published online: September 15, 2025 Processing time: 308 Days and 16.5 Hours
Abstract
The article by Yuan et al accessed the clinicopathologic and prognostic significance of the patterns of lymph node (LN) metastasis in upper and lower gastric cancer (GC). In this article, we will analyze both the strengths and limitations of this paper. The study’s methodology seems appropriate and proper statistical analyses were applied to identify significant variables. The authors applied the Cox regression model to identify independent risk factors and Kaplan-Meier survival curves to assess prognosis. The researchers found notable differences in clinicopathologic variables between patients with upper and lower GC. Additionally, they identified specific LN stations more prone to metastasis in different Siewert classifications of GC. Despite the study’s detailed analysis, it would have been beneficial to explore whether there were survival differences among upper GC patients based on the Siewert classification. Furthermore, the study should have addressed potential confounding factors that might have influenced the results. A more comprehensive analysis could have been achieved by comparing survival outcomes based on LN metastasis patterns. Overall, this article is relevant and provides valuable insights into the significance of LN metastasis patterns in upper GC patients.
Core Tip: Upper gastric cancer (GC) has a significantly greater degree of malignancy than lower GC. In upper GC, the rate of lymph node (LN) metastasis was greater in groups number 1, 2, 3, and 7 among the different subtypes. In lower GC, the rate of LN metastasis was greater in groups number 3-8. Pathological type, histological grade, tumor stage, tumor-node-metastasis stage, and vascular invasion independently influenced the occurrence of LN metastasis. Age, pathological type, tumor stage, nodes stage, tumor-node-metastasis stage, vascular invasion, and absence of adjuvant chemotherapy independently influenced the prognosis.
