Abstract
Background
Sentinel node-guided surgery has received increasing attention in tumor surgery. To ascertain whether sentinel lymph node (SLN)-guided surgery is feasible for gastric cancers 4 cm or less in size, we conducted a multicenter clinical study.
Methods
One milliliter of isosulfan blue was injected endoscopically into the gastric wall at four sites around a gastric cancer lesion. Approximately 15 min after the injection of the dye, the surgeons resected (picked-up) the stained blue nodes (defined as SLNs) around the stomach.
Results
SLNs were detected in 140 of 144 patients (97.2%). The average number of SLNs was 3.3. In 99 patients with D2 lymph node dissection, the false-negative rate (FNR) was evaluated. In 14 T1 patients with pathological positive lymph node metastasis (pN(+)), the FNR was 29%. In 9 T2,3 pN(+) patients, the FNR was 44%. In T1 patients with pN(+) but macroscopically normal lymph nodes during surgery (sN0), the FNR was 11% (1/9).
Conclusion
T1 and sN0 patients may be a target group for the study of SLN-guided surgery. A larger multicenter trial should be performed to clarify the application of sentinel node navigation surgery for gastric cancer.
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* Members of the EGI group are the First Department of Surgery of Okayama University Hospital; Satoh Hospital; Kaneda Hospital; Hiroshima City Hospital; Fukuyama National Hospital; Onomichi Citizens Hospital; Okayama Saiseikai Hospital; Matsuyama Citizens Hospital; Himeji Central Hospital; Oomoto Hospital; Tsuyama Central Hospital; Kagawa Rohsai Hospital; Matsuda Hospital; and Mihara Red Cross Hospital.
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Isozaki, H., Kimura, T., Tanaka, N. et al. An assessment of the feasibility of sentinel lymph node-guided surgery for gastric cancer. Gastric Cancer 7, 149–153 (2004). https://doi.org/10.1007/s10120-004-0283-6
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DOI: https://doi.org/10.1007/s10120-004-0283-6