Lamprecht CB, Kashuv T, Lucke-Wold B. Understanding metastatic patterns in gastric cancer: Insights from lymph node distribution and pathology. World J Gastrointest Oncol 2025; 17(4): 103709 [DOI: 10.4251/wjgo.v17.i4.103709]
Corresponding Author of This Article
Brandon Lucke-Wold, MD, PhD, Lillian S. Wells Department of Neurosurgery, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, United States. brandon.lucke-wold@neurosurgery.ufl.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
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. Apr 15, 2025; 17(4): 103709 Published online Apr 15, 2025. doi: 10.4251/wjgo.v17.i4.103709
Understanding metastatic patterns in gastric cancer: Insights from lymph node distribution and pathology
Chris B Lamprecht, Tyler Kashuv, Brandon Lucke-Wold
Chris B Lamprecht, Tyler Kashuv, Brandon Lucke-Wold, Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL 32608, United States
Co-first authors: Chris B Lamprecht and Tyler Kashuv.
Author contributions: Lamprecht CB and Kashuv T contributed to literature research, manuscript composition, editing, and revisions following peer review process; Lucke-Wold B contributed to conceptualization and editing the manuscript. Lamprecht CB and Kashuv T contributed equally to this work as co-first authors.
Conflict-of-interest statement: The authors report no conflicts of interest.
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: Brandon Lucke-Wold, MD, PhD, Lillian S. Wells Department of Neurosurgery, University of Florida, 1505 SW Archer Rd, Gainesville, FL 32608, United States. brandon.lucke-wold@neurosurgery.ufl.edu
Received: November 28, 2024 Revised: January 26, 2025 Accepted: February 17, 2025 Published online: April 15, 2025 Processing time: 118 Days and 4.4 Hours
Abstract
Gastric cancer (GC) represents a significant global health burden due to its high morbidity and mortality. Specific behaviors of GC sub-types, distinct dissemination patterns, and associated risk-factors remain poorly understood. This editorial highlights several key prognostic factors, including pathological staging and vascular invasion, that impact GC. It examines a recent study’s investigation of differential metastatic lymph nodes distribution and survival in upper and lower GC sub-types, focusing on histological characterization, pathophysiology, usage of neoadjuvant chemotherapy, and additional predictive determinants. We assess the statistical robustness and clinical applicability of the findings, underscoring the importance of treating GC as a heterogeneous disease and emphasizing how tailored surgical approaches informed by lymph node distribution can optimize tumor detection while minimizing unnecessary interventions. The study’s large cohort, multi-center design, and strict inclusion criteria strengthen its validity in guiding surgical planning and risk-stratification. However, integrating genetic and molecular data is critical for refining models and broadening applicability. Additionally, recurrence-metrics and infection-related factors, such as Helicobacter pylori and Epstein-Barr virus, absent in the original study, remain vital for directing future research. By bridging metastatic patterns with prospective methodologies and inclusion of diverse populations, this editorial provides a framework for advancing early detection and personalized GC care.
Core Tip: Gastric cancer (GC) remains a leading cause of cancer-related mortality worldwide, underscoring the need for improved detection and management strategies. This editorial emphasizes the importance of personalized approaches to GC management by examining distinct metastatic lymph node distributions and prognostic factors in upper and lower GC. Future research can incorporate critical variables such as genomic and molecular characterization, infection-related factors like Helicobacter pylori and Epstein-Barr virus, and recurrence metrics. Incorporating these factors into patient predictive models offers promising opportunities to enhance understanding of GC and inform tailored, patient-centered treatment modalities across diverse populations.
