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Sentinel Node Biopsy Using Dye and Isotope Double Tracers in Early Gastric Cancer

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Abstract

Background

The results of sentinel node (SN) biopsy have been improved by the use of dye and isotope double tracers in melanoma and breast cancer. However, the usefulness of this double tracer technique has not been determined in gastric cancer. The aim of this study was to investigate the possibility of improving SN biopsy results by using double tracers in gastric cancer.

Methods

Sixty-four gastric adenocarcinoma patients preoperatively diagnosed as cT1N0, were enrolled in the study. 99mTc tin colloid was injected by preoperative endoscopy, and lymphoscintigraphy was performed prior to operation. After laparotomy, isosulfan blue was intraoperatively injected using an endoscope. Blue-stained or radioactive nodes were identified and defined as SNs. Gastrectomy with D2 lymphadenectomy was performed in all patients. All dissected lymph nodes were evaluated for metastasis by hematoxylin and eosin staining and immunohistochemistry.

Results

SN detection rates using dye, isotope, or both tracers were 95.3%, 84.4%, and 96.9%, respectively, and their corresponding sensitivities were 52.9%, 52.9%, and 70.6%. In the pT1 subset, the sensitivity of the double tracer was 87.5%; and in a subset of tumors with diameter <4.5 cm, this was also 87.5%.

Conclusions

These findings confirm that SN biopsy results are improved by using double tracers in gastric cancer and suggest that SN biopsy is suitable in cases of small-sized early gastric cancer.

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Acknowledgements

This work was supported by grant 0310020 from the National Cancer Center, South Korea. The authors thank Dr. Byung-Ho Nam (Cancer Biostatistics Branch, National Cancer Center, South Korea) for statistical revision of the manuscript.

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Authors and Affiliations

  1. Research Institute and Hospital, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, South Korea

    Jun Ho Lee MD, Keun Won Ryu MD, Chan Gyoo Kim MD, Seok-Ki Kim MD, Jong-Seok Lee MD, Myeong-Cherl Kook MD, Il Ju Choi MD, Young Woo Kim MD, Hee Jin Chang MD & Jae-Moon Bae MD

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  1. Jun Ho Lee MD
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  2. Keun Won Ryu MD
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  3. Chan Gyoo Kim MD
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  5. Jong-Seok Lee MD
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Correspondence to Keun Won Ryu MD.

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Lee, J.H., Ryu, K.W., Kim, C.G. et al. Sentinel Node Biopsy Using Dye and Isotope Double Tracers in Early Gastric Cancer. Ann Surg Oncol 13, 1168–1174 (2006). https://doi.org/10.1245/s10434-006-9038-4

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  • DOI: https://doi.org/10.1245/s10434-006-9038-4

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