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Possibility of limited gastrectomy for early gastric cancer located in the upper third of the stomach, based on the distribution of sentinel node basins

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Abstract

Purpose

Several recent studies have evaluated the feasibility of the sentinel node (SN) concept for gastric cancer. The aim of our study was to investigate limited gastrectomy with SN basin dissection in SN navigation surgery (SNNS) for patients with early-gastric cancer located in the upper-third of the stomach.

Methods

147 patients received SNNS for early-gastric cancer at our institution. Of these, 26 patients diagnosed with early-gastric cancer < 4 cm in size and located in the upper-third of the stomach were retrospectively analyzed for the distribution of SN and SN basins.

Results

In three of the 26 patients, lymph node metastasis was limited to the left gastric artery (LGA) basin. The breakdown of the basins were as follows: A single LGA basin, 19 cases; a non-single LGA basin, seven cases. A non-single LGA basin was significantly associated with the clinicopathological factors, such as tumor spread to the middle-third of the stomach, tumor location at the center of the greater curvature, and undifferentiated adenocarcinoma, compared to the single LGA basin group.

Conclusions

Our data revealed that the distribution of the SN basins in early-gastric cancer measuring less than 4 cm in size and located in the upper-third of the stomach was significantly correlated with tumor spread, tumor location, and the pathological findings.

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Authors and Affiliations

  1. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, 514-8507, Mie, Japan

    Masaki Ohi, Yuji Toiyama, Yusuke Omura, Takashi Ichikawa, Hiromi Yasuda, Yoshinaga Okugawa, Hiroyuki Fujikawa, Shigeyuki Yoshiyama, Junichiro Hiro, Toshimitsu Araki & Masato Kusunoki

  2. Department of Innovative Surgery, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, 514-8507, Mie, Japan

    Yoshiki Okita & Masato Kusunoki

Authors
  1. Masaki Ohi
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  2. Yuji Toiyama
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  3. Yusuke Omura
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  4. Takashi Ichikawa
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  5. Hiromi Yasuda
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  6. Yoshinaga Okugawa
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  7. Hiroyuki Fujikawa
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  8. Yoshiki Okita
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  9. Shigeyuki Yoshiyama
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  10. Junichiro Hiro
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  11. Toshimitsu Araki
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  12. Masato Kusunoki
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Corresponding author

Correspondence to Masaki Ohi.

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Conflict of interest

The authors declare no conflicts of interest and received no financial support for this study.

Ethical statement

All procedures and subsequent analyses were performed with the approval of the Institutional Review Boards of Mie University Hospital in Japan (No. 2004 − 445). The study was conducted in accordance with the guidelines of the 1975 Declaration of Helsinki.

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Written informed consent was obtained from all study participants.

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Ohi, M., Toiyama, Y., Omura, Y. et al. Possibility of limited gastrectomy for early gastric cancer located in the upper third of the stomach, based on the distribution of sentinel node basins. Surg Today 49, 529–535 (2019). https://doi.org/10.1007/s00595-019-1768-6

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  • DOI: https://doi.org/10.1007/s00595-019-1768-6

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