Skip to main content

Advertisement

Log in

Sentinel node navigation surgery for esophageal cancer

  • Current Topics Review Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Although sentinel node (SN) biopsy has been utilized to predict regional lymph node metastasis in patients with melanoma and breast cancer, the validity of the SN hypothesis is still controversial in regard to esophageal cancer. SN mapping for esophageal cancer is relatively complicated compared to that for gastric cancer, and the number of early-stage esophageal cancers is limited. Therefore, only a few studies have demonstrated the feasibility and validity of the SN concept for esophageal cancer. Nevertheless, our preliminary studies showed that SN mapping may be feasible in patients with early-stage esophageal cancer. Transthoracic extended esophagectomy with three-field radical lymph node dissection has been recognized as a curative procedure for thoracic esophageal cancer in Japan. However, uniform application of this highly invasive procedure might increase the morbidity and markedly reduce quality of life (QOL) after surgery. Although further accumulation of evidence based on multicenter clinical trials using standard protocol is required, SN mapping would provide significant information on individualized selective lymphadenectomy, which might reduce the morbidity and retain the patients’ QOL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al. Techinical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 1992;127:392–399.

    PubMed  CAS  Google Scholar 

  2. Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 1994;220:391–401.

    Article  PubMed  CAS  Google Scholar 

  3. Morton DL, Thompson JF, Essner R, Stern SL, Nieweg OE, Roses DF, et al. Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial; Multicenter Selective Lymphadenectomy Trial Group. Ann Surg 1999;230:453–463.

    Article  PubMed  CAS  Google Scholar 

  4. Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, et al. The sentinel node in breast cancer: a multicenter validation study. N Engl J Med 1998;339:941–946.

    Article  PubMed  CAS  Google Scholar 

  5. Bilchik AJ, Saha S, Wiese D, Stonecypher JA, Wood TF, Sostrin S, et al. Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial. J Clin Oncol 2001;19:1128–1136.

    PubMed  CAS  Google Scholar 

  6. Kitagawa Y, Fujii H, Mukai M, Kubota T, Ando N, Watanabe M, et al. The role of the sentinel lymph node in gastrointestinal cancer. Surg Clin North Am 2000;80:1799–1809.

    Article  PubMed  CAS  Google Scholar 

  7. Ando N, Ozawa S, Kitagawa Y, Shinozawa Y, Kitajima M. Improvement in the results of surgical treatment of advanced squamous esophageal carcinoma during 15 consecutive years. Ann Surg 2000;232:225–232.

    Article  PubMed  CAS  Google Scholar 

  8. Akiyama H, Tsurumaru M, Udagawa H, Kajiyama Y. Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg 1994;220:360–373.

    Article  Google Scholar 

  9. Fujita H, Kakegawa T, Yamana H, Shima I, Toh Y, Tomita Y, et al. Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer: comparison of three-field lymphadenectomy with two-field lymphadenectomy. Ann Surg 1995;222:654–662.

    Article  PubMed  CAS  Google Scholar 

  10. Kinugasa S, Tachibana M, Yoshimura H, Ueda S, Fujii T, Dhar DK, et al. Postoperative pulmonary complications are associated with worse short-and long-term outcomes after extended esophagectomy. J Surg Oncol 2004;88:71–77.

    Article  PubMed  Google Scholar 

  11. Fang WT, Chen WH, Chen Y, Jiang Y. Selective three-field lymphadenectomy for thoracic esophageal squamous carcinoma. Dis Esophagus 2007;20:206–211.

    Article  PubMed  Google Scholar 

  12. Kitagawa Y, Fujii H, Mukai M, Kubota T, Ando N, Ozawa S, et al. Intraoperative lymphatic mapping and sentinel lymph node sampling in esophageal and gastric cancer. Surg Oncol Clin North Am 2002;11:293–304.

    Article  Google Scholar 

  13. Kato H, Miyazaki T, Nakajima M, Takita J, Sohda M, Fukai Y, et al. Sentinel lymph nodes with technetium-99m colloidal rhenium sulfide in patients with esophageal carcinoma. Cancer 2003;98:932–939.

    Article  PubMed  Google Scholar 

  14. Lamb PJ, Griffin SM, Burt AD, Lloyd J, Karat D, Hayes N. Sentinel node biopsy to evaluate the metastatic dissemination of oesophageal adenocarcinoma. Br J Surg 2005;92:60–67.

    Article  PubMed  CAS  Google Scholar 

  15. Arima H, Natsugoe S, Uenosono Y, Arigami T, Ehi K, Yanagita S, et al. Area of nodal metastasis and radioisotope uptake in sentinel nodes of upper gastrointestinal cancer. J Surg Res 2006;135:250–254.

    Article  PubMed  CAS  Google Scholar 

  16. Takeuchi H, Kitajima M, Kitagawa Y. Sentinel lymph node as a target of molecular diagnosis of lymphatic micrometastasis and local immunoresponse to malignant cells. Cancer Sci 2008;99:441–456.

    Article  PubMed  CAS  Google Scholar 

  17. Kitagawa Y, Mukai M, Nakahara T, Saikawa Y, Takeuchi H, Kubo A, et al. Clinical significance of molecular metastasis in sentinel lymph nodes of esophageal cancer. Esophagus 2007;4:19–22.

    Article  Google Scholar 

  18. Kitajima M, Kitagawa Y. Surgical treatment of esophageal cancer: the advent of the era of individualization. N Engl J Med 2002;347:1705–1709.

    Article  PubMed  Google Scholar 

  19. Ando N, Iizuka T, Ide H, Ishida K, Shinoda M, Nishimaki T, et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group study—JCOG 9204. J Clin Oncol 2003;21:4592–4596.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hiroya Takeuchi.

Additional information

This review was submitted at the invitation of the editorial committee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Takeuchi, H., Kitagawa, Y. Sentinel node navigation surgery for esophageal cancer. Gen Thorac Cardiovasc Surg 56, 393–396 (2008). https://doi.org/10.1007/s11748-008-0264-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-008-0264-5

Key words

Navigation