Abstract
Sentinel node (SN) biopsies might be useful for performing minimally invasive surgery without interrupting surgical curability. This study examined the cause of false negativity during laparoscopic lymphatic mapping and SN biopsies for early-stage gastric cancer. Thirty-seven patients with gastric cancer (preoperative stage T1-2 or N0) who underwent laparoscopic lymph node mapping and SN biopsies between March 2001 and June 2004 were enrolled in this study. The tracer, patent blue and technecium-99m-labeled tin colloid, was injected endoscopically. Blue-stained or radioactive nodes were defined as SNs. Gastrectomy with lymphadenectomy was performed then the results of the SN biopsies were compared with the final diagnosis of the removed lymph nodes in permanent sections. Sentinel nodes were successfully identified in 35 patients (94.6%), and they were positive in 3 of 4 patients with metastatic lymph nodes; sensitivity was 75% and specificity was 100%. Sentinel node status could therefore be used to diagnose lymph node status with 97.1% accuracy. Of 6 SNs with metastasis, 5 showed radioactivity, and only 2 were blue stained. In the false negative case, a radioactive SN with metastasis in the right paracardial region was missed during laparoscopic mapping. An error in laparoscopic intracorporeal detection of the radioactive node with metastasis occurred because we could not eliminate the shine-through effect. We found that during laparoscopic SN mapping there is a high risk of false negativity with SNs located in the right paracardial region. To apply laparoscopic SN mapping to early-stage gastric cancer patients, the shine-through effect must be eliminated because radiotracers are essential for this method.
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U.S. National Institutes of Health Web site. Clinical trials information available from: http://clinicaltrials.gov/ct/gui/info/about
Y Kitagawa H Fujii M Mukai et al. (2002) ArticleTitleRadio-guided sentinel node detection for gastric cancer Br. J. Surg. 89 604–608 Occurrence Handle10.1046/j.1365-2168.2002.02065.x Occurrence Handle11972551 Occurrence Handle1:STN:280:DC%2BD383jsFehtQ%3D%3D
JC Hundley P Shen SA Shiver et al. (2002) ArticleTitleLymphatic mapping for gastric adenocarcinoma Am. Surg. 68 931–935 Occurrence Handle12455783
M Carlini F Carboni M Petric et al. (2002) ArticleTitleSentinel node in gastric cancer surgery J. Exp. Clin. Cancer Res. 21 469–473 Occurrence Handle12636091 Occurrence Handle1:STN:280:DC%2BD3s7it1Slug%3D%3D
H Hayashi T Ochiai M Mori et al. (2003) ArticleTitleSentinel lymph node mapping for gastric cancer using a dual procedure with and gamma probe-guided techniques J. Am. Coll. Surg. 196 68–74 Occurrence Handle10.1016/S1072-7515(02)01594-6 Occurrence Handle12517553
J Simsa J Hoch J Leffler et al. (2003) ArticleTitleSentinel node biopsy in gastric cancer: preliminary results Acta Chir. Belg. 103 270–273 Occurrence Handle12914360 Occurrence Handle1:STN:280:DC%2BD3sznvVOltw%3D%3D
M Shiozawa M Kawamoto N Ishiwa et al. (2003) ArticleTitleClinical usefulness of intraoperative sentinel-node biopsy in gastric cancer Hepatogastroenterology 50 1187–1189 Occurrence Handle12846011
KW Ryu JH Lee HS Kim et al. (2003) ArticleTitlePrediction of lymph nodes metastasis by sentinel node biopsy in gastric cancer Eur. J. Surg. Oncol. 29 895–899 Occurrence Handle10.1016/j.ejso.2003.09.008 Occurrence Handle14624784 Occurrence Handle1:STN:280:DC%2BD3srksF2mtw%3D%3D
X Song L Wang W Chen et al. (2004) ArticleTitleLymphatic mapping and sentinel node biopsy in gastric cancer Am. J. Surg. 187 270–273 Occurrence Handle10.1016/j.amjsurg.2003.11.013 Occurrence Handle14769318
H Nimura N Narimiya N Mitsumori et al. (2004) ArticleTitleInfrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer Br. J. Surg. 91 575–579 Occurrence Handle10.1002/bjs.4470 Occurrence Handle15122608 Occurrence Handle1:STN:280:DC%2BD2c3it1answ%3D%3D
H Tonouchi Y Mohri K Tanaka et al. (2003) ArticleTitleLymphatic mapping and sentinel node biopsy during laparoscopic gastrectomy for early cancer Dig. Surg. 20 421–427 Occurrence Handle10.1159/000072710 Occurrence Handle12900533
InstitutionalAuthorNameJapanese Gastric Cancer Association (1998) ArticleTitleJapanese Classification of Gastric Carcinoma (2nd English Ed.) Gastric Cancer 1 10–24 Occurrence Handle11957040
Schwartz GF, Giuliano AE, Veronesi U; Consensus Conference Committee. Proceedings of the Consensus conference on the Role of Sentinel Lymph Node Biopsy in Carcinoma of the Breast. April 19 to 22, 2001, Philadelphia, Pennsylvania. Hum Pathol. 2002;33:579–589
M Hiratsuka I Miyashiro O Ishikawa et al. (2001) ArticleTitleApplication of sentinel node biopsy to gastric cancer surgery Surgery 129 335–340 Occurrence Handle10.1067/msy.2001.111699 Occurrence Handle11231462 Occurrence Handle1:STN:280:DC%2BD3M7mt1yisQ%3D%3D
T Ichikura D Morita T Uchida et al. (2002) ArticleTitleSentinel node concept in gastric carcinoma World J. Surg. 26 318–322 Occurrence Handle11865368
K Miwa S Kinami K Taniguchi et al. (2003) ArticleTitleMapping sentinel nodes in patients with early-stage gastric carcinoma Br. J. Surg. 90 178–182 Occurrence Handle10.1002/bjs.4031 Occurrence Handle12555293 Occurrence Handle1:STN:280:DC%2BD3s%2FksVymsw%3D%3D
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Tonouchi, H., Mohri, Y., Tanaka, K. et al. Laparoscopic Lymphatic Mapping and Sentinel Node Biopsies for Early-stage Gastric Cancer: The Cause of False Negativity. World J. Surg. 29, 418–421 (2005). https://doi.org/10.1007/s00268-004-7732-6
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DOI: https://doi.org/10.1007/s00268-004-7732-6