Potential for local resection with sentinel node basin dissection for early gastric cancer based on the distribution of primary sites
- 9 Downloads
Based on the sentinel node (SN) concept, function-preserving surgery with SN basin dissection (SNBD) can be performed for SN-negative early gastric cancers. Particularly, a resection area can be minimized when the SN basin and primary site are closely localized. The aim of this study was to compare probabilities of being candidates for local resection with SNBD based on tumor location among patients with early gastric cancer.
We retrospectively analyzed 358 patients who underwent surgery with SN mapping for gastric cancer in our institution from November 1999 to April 2014. The proportion of patients who had a localized single basin and the distributions of the SN basins and primary sites were investigated. Patients with single basin drainage excluding remote sentinel node basin were considered as candidates for local resection with SNBD.
Of the 358 patients, 191 (53%) patients were considered eligible for local resection with SNBD. Patients with tumors located in the upper third of the stomach were more likely candidates for local resection than those with tumors in other locations (upper third, 68%; middle third, 50%; and lower third, 51%), whereas patients with tumors located in the anterior wall were less likely candidates than those with tumors other locations (anterior wall, 31%; posterior wall, 58%; greater curvature, 55%; and lesser curvature, 57%).
We found that > 50% of the patients indicated for SN navigation surgery, particularly those with tumors in the upper third of the stomach, potentially could undergo partial resection with SNBD.
KeywordsMinimally invasive surgery Sentinel node navigation surgery Local resection Early gastric cancer
Compliance with ethical standards
All the procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.
Informed consent was obtained from all patients for inclusion in the study.
Conflict of interest
Yuko Kitagawa received designated donation from Daiichi Sankyo Co., Ltd.
- 14.Goto O, Takeuchi H, Kawakubo H, Matsuda S, Kato F, Sasaki M, et al. Feasibility of non-exposed endoscopic wall-inversion surgery with sentinel node basin dissection as a new surgical method for early gastric cancer: a porcine survival study. Gastric Cancer. 2015;18:440–5.CrossRefPubMedGoogle Scholar
- 16.UCC. TNM classification of malignant tumours. Weinheim: Wiley; 2009.Google Scholar
- 27.Park JY, Kim YW, Ryu KW, Nam BH, Lee YJ, Jeong SH, et al. Assessment of laparoscopic stomach preserving surgery with sentinel basin dissection versus standard gastrectomy with lymphadenectomy in early gastric cancer—a multicenter randomized phase III clinical trial (SENORITA trial) protocol. BMC Cancer. 2016;16:340.CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Shimizu Y, Takeuchi H, Sakakura Y, Saikawa Y, Nakahara T, Mukai M, et al. Molecular detection of sentinel node micrometastases in patients with clinical N0 gastric carcinoma with real-time multiplex reverse transcription-polymerase chain reaction assay. Ann Surg Oncol. 2012;19:469–77.CrossRefPubMedGoogle Scholar