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The Results of Sentinel Node Mapping for Patients with Clinically Early Staged Gastric Cancer Diagnosed with pT2/deeper Tumors

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Abstract

Background

Sentinel node (SN) mapping based on the SN concept has been applied to early gastric cancer. However, it is still controversial whether or not the oncological safety is ensured in case pathological stage was advanced in these patients. The aim of this study was to investigate the validity of SN mapping in patients with clinically early staged gastric cancer diagnosed with pT2/deeper tumors.

Methods

We retrospectively analyzed 40 patients with a diagnosis of cT1N0 or cT2N0 single-lesion gastric cancer who were shown to have pT2 or deeper tumors after gastrectomy with SN mapping. We adopted a dual-tracer method using a radioactive colloid and blue dye to detect SNs. The diagnostic accuracy and distribution of SNs at each tumor site were analyzed.

Results

Of the 40 patients, 24 (60%) were postoperatively diagnosed as pT2, and 16 (40%) as pT3 or T4. SNs were detected in all patients. The false negative rate was 9% (1/11), and in that patient, the non-SN metastasis was observed within the SN basin. Diagnostic accuracy was 98% (39/40). Overall distribution of SNs was similar to that for patients with early gastric cancer. No significant differences in overall and recurrence-free survival were observed between the patients who underwent standard gastrectomy and those who underwent function-preserving gastrectomy, based on the results of SN mapping.

Conclusions

Our results confirmed validity of SN mapping for patients with clinically early staged gastric cancer diagnosed with pT2/deeper tumors after gastrectomy. Closed surveillance without additional surgical treatment is an option for these patients.

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Abbreviations

p:

Pathological

SN:

Sentinel node

LN:

Lymph node

OS:

Overall survival

RFS:

Recurrence-free survival

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Acknowledgements

The authors thank Kumiko Motooka, who is a staff member at the Department of Surgery in the Keio University School of Medicine, for her help in the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Masashi Takeuchi, Hirofumi Kawakubo, Ayako Shimada, Shota Hoshino, Satoru Matsuda, Shuhei Mayanagi, Tomoyuki Irino, Kazumasa Fukuda, Rieko Nakamura, Norihito Wada, Hiroya Takeuchi & Yuko Kitagawa

  2. Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare, Narita Hospital, Chiba, 286-8520, Japan

    Ayako Shimada

  3. Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan

    Hiroya Takeuchi

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  1. Masashi Takeuchi
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  2. Hirofumi Kawakubo
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  11. Hiroya Takeuchi
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Correspondence to Hirofumi Kawakubo.

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Conflict of interest

Dr. Kitagawa reports grants and personal fees from AsahiKASEI Co., Ltd., grants and personal fees from TAIHO PHARMACEUTICAL CO., LTD, grants and personal fees from CHUGAI PHARMACEUTICAL CO., LTD., grants from DAIICHI SANKYO COMPANY, LIMITED, grants from Merck Serono Co., Ltd., grants and personal fees from EA Pharma Co., Ltd., grants and personal fees from Yakult Honsha Co. Ltd., grants and personal fees from Otsuka Pharmaceutical Co., Ltd., grants from Takeda Pharmaceutical Co., Ltd., grants and personal fees from Otsuka Pharmaceutical Factory Inc., grants and personal fees from SHIONOGI & CO., LTD., grants from KAKEN PHARMACEUTICAL CO.,LTD., grants from Kowa Pharmaceutical Co., Ltd., grants and personal fees from Astellas Pharma Inc., grants from MEDICON INC., grants and personal fees from DAINIPPON SUMITOMO PHARMA Co., Ltd., grants and personal fees from Taisho Toyama Pharmaceutical Co., Ltd., grants from Kyouwa Hakkou Kirin Co., Ltd., grants from Pfizer Japan Inc., grants and personal fees from ONO PHARMACEUTICAL CO., LTD., grants and personal fees from NIHON PHARMACEUTICAL CO., LTD., grants from Japan Blood Products Organization, grants from Medtronic Japan Co., Ltd., grants and personal fees from Sanofi K.K., grants from Eisai Co., Ltd., grants from TSUMURA & CO., grants from KCI Licensing, Inc., grants from ABBOTT JAPAN CO., LTD., grants from FUJIFILM Toyama Chemical Co., Ltd., outside the submitted work;.

Ethical Approval

All procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and within the requirements of the 1964 Declaration of Helsinki and later versions. Informed consent or substitute for it was obtained from all patients included in the study.

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Takeuchi, M., Kawakubo, H., Shimada, A. et al. The Results of Sentinel Node Mapping for Patients with Clinically Early Staged Gastric Cancer Diagnosed with pT2/deeper Tumors. World J Surg 45, 3350–3358 (2021). https://doi.org/10.1007/s00268-021-06254-6

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  • DOI: https://doi.org/10.1007/s00268-021-06254-6

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