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Long-Term Oncologic Outcomes of Laparoscopic Sentinel Node Navigation Surgery in Early Gastric Cancer: A Single-Center, Single-Arm, Phase II Trial

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Sentinel node navigation surgery (SNNS) in early gastric cancer (EGC) is technically feasible according to previous literature, however its long-term oncologic safety has not been reported.

Methods

A single-center, single-arm, phase II trial was conducted to determine the oncologic outcomes of laparoscopic sentinel node (SN) biopsy in clinical stage T1N0M0 gastric cancer patients. Cases with positive SNs on intraoperative pathologic examination underwent conventional gastrectomy with radical lymphadenectomy (SN-positive group), whereas those with negative SNs underwent laparoendoscopic-limited gastric resections without further lymph node dissections (SN-negative group). The primary endpoint was 3-year relapse-free survival.

Results

Between July 2010 and April 2013, 113 patients were enrolled, with 100 patients being included in the final analysis. SNs were detected in 99 patients. The mean number of identified SNs was 6.1 ± 3.9. Eleven patients were included in the SN-positive group and 89 in the SN-negative group. After a median follow-up period of 46.4 months, four patients died and three showed cancer recurrence. All recurrences occurred on the remnant stomach after endoscopic submucosal resection or wedge resection in the SN-negative group. The 3-year relapse-free and overall survival rates were 96.0% (95% confidence interval [CI] 92.2–100.0%) and 98.0% (95% CI 95.2–100.0%), respectively.

Conclusions

Our results indicate that laparoscopic SNNS may be oncologically safe in EGC. Limited gastric resections should be carefully performed to prevent local recurrence in SN-negative cases. A randomized controlled trial is needed based on the present study.

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Funding

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare, and Family Affairs, Republic of Korea (A085125).

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Authors and Affiliations

  1. Department of Surgery, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea

    Do Joong Park MD, PhD, Young Suk Park MD, Sang Yong Son MD, Ju-Hee Lee MD, PhD, Sang-Hoon Ahn MD & Hyung-Ho Kim MD, PhD

  2. Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Hye Seung Lee MD, PhD

  3. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Young Soo Park MD, PhD

  4. Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Kyoung Ho Lee MD, PhD & Young Hoon Kim MD, PhD

  5. Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Kyoung Un Park MD, PhD

  6. Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Won Woo Lee MD, PhD

  7. Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Soyeon Ahn PhD

Authors
  1. Do Joong Park MD, PhD
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  2. Young Suk Park MD
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  3. Sang Yong Son MD
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  4. Ju-Hee Lee MD, PhD
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  5. Hye Seung Lee MD, PhD
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  6. Young Soo Park MD, PhD
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  7. Kyoung Ho Lee MD, PhD
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  8. Young Hoon Kim MD, PhD
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  9. Kyoung Un Park MD, PhD
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  10. Won Woo Lee MD, PhD
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  11. Soyeon Ahn PhD
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  12. Sang-Hoon Ahn MD
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  13. Hyung-Ho Kim MD, PhD
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Corresponding author

Correspondence to Hyung-Ho Kim MD, PhD.

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Park, D.J., Park, Y.S., Son, S.Y. et al. Long-Term Oncologic Outcomes of Laparoscopic Sentinel Node Navigation Surgery in Early Gastric Cancer: A Single-Center, Single-Arm, Phase II Trial. Ann Surg Oncol 25, 2357–2365 (2018). https://doi.org/10.1245/s10434-018-6523-5

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  • DOI: https://doi.org/10.1245/s10434-018-6523-5

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