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Surgery Today
Published in: Surgery Today 6/2019

01-06-2019 | Metastasis | Original Article

Possibility of limited gastrectomy for early gastric cancer located in the upper third of the stomach, based on the distribution of sentinel node basins

Authors: Masaki Ohi, Yuji Toiyama, Yusuke Omura, Takashi Ichikawa, Hiromi Yasuda, Yoshinaga Okugawa, Hiroyuki Fujikawa, Yoshiki Okita, Shigeyuki Yoshiyama, Junichiro Hiro, Toshimitsu Araki, Masato Kusunoki

Published in: Surgery Today | Issue 6/2019

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Abstract

Purpose

Several recent studies have evaluated the feasibility of the sentinel node (SN) concept for gastric cancer. The aim of our study was to investigate limited gastrectomy with SN basin dissection in SN navigation surgery (SNNS) for patients with early-gastric cancer located in the upper-third of the stomach.

Methods

147 patients received SNNS for early-gastric cancer at our institution. Of these, 26 patients diagnosed with early-gastric cancer < 4 cm in size and located in the upper-third of the stomach were retrospectively analyzed for the distribution of SN and SN basins.

Results

In three of the 26 patients, lymph node metastasis was limited to the left gastric artery (LGA) basin. The breakdown of the basins were as follows: A single LGA basin, 19 cases; a non-single LGA basin, seven cases. A non-single LGA basin was significantly associated with the clinicopathological factors, such as tumor spread to the middle-third of the stomach, tumor location at the center of the greater curvature, and undifferentiated adenocarcinoma, compared to the single LGA basin group.

Conclusions

Our data revealed that the distribution of the SN basins in early-gastric cancer measuring less than 4 cm in size and located in the upper-third of the stomach was significantly correlated with tumor spread, tumor location, and the pathological findings.
Literature
1.
Morton DL, Thompson JF, Essner R, Elashoff R, Stern SL, Nieweg OE, et al. Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Ann Surg. 1999;230:453–63.CrossRefPubMedPubMedCentral
2.
Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349:546–53.CrossRefPubMed
3.
Hiratsuka M, Miyashiro I, Ishikawa O, Furukawa H, Motomura K, Ohigashi H, et al. Application of sentinel node biopsy to gastric cancer surgery. Surgery. 2001;129:335–40.CrossRefPubMed
4.
Miwa K, Kinami S, Taniguchi K, Fushida S, Fujimura T, Nonomura A. Mapping sentinel nodes in patients with early-stage gastric carcinoma. Br J Surg. 2003;90:178–82.CrossRefPubMed
5.
Kitagawa Y, Saikawa Y, Takeuchi H, Mukai M, Nakahara T, Kubo A, et al. Sentinel node navigation in early stage gastric cancer—updated data and current status. Scand J Surg. 2006;95:256–9.CrossRefPubMed
6.
Kinami S, Fujimura T, Ojima E, Fushida S, Ojima T, Funaki H, et al. PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow. Int J Clin Oncol. 2008;13:320–9.CrossRefPubMed
7.
Adachi Y, Inoue T, Hagino Y, Shiraishi N, Shimoda K, Kitano S. Surgical results of proximal gastrectomy for early-stage gastric cancer: jejunal interposition and gastric tube reconstruction. Gastric Cancer. 1999;2:40–50.CrossRefPubMed
8.
Katai H, Sano T, Fukagawa T, Shinohara H, Sasako M. Prospective study of proximal gastrectomy for early gastric cancer in the upper third of the stomach. Br J Surg. 2003;90:850–3.CrossRefPubMed
9.
Kosuga T, Ichikawa D, Komatsu S, Okamoto K, Konishi H, Shiozaki A, et al. Feasibility and nutritional benefits of laparoscopic proximal gastrectomy for early gastric cancer in the upper stomach. Ann Surg Oncol. 2015;22 (Suppl 3):S929–35.CrossRef
10.
Kinami S, Funaki H, Fujita H, Nakano Y, Ueda N, Kosaka T. Local resection of the stomach for gastric cancer. Surg Today. 2017;47(6):651–9.CrossRefPubMed
11.
Ichikura T, Sugasawa H, Sakamoto N, Yaguchi Y, Tsujimoto H, Ono S. Limited gastrectomy with dissection of sentinel node stations for early gastric cancer with negative sentinel node biopsy. Ann Surg. 2009;249(6):942–7.CrossRefPubMed
12.
Shimada A, Takeuchi H, Ono T, Kamiya S, Fukuda K, Nakamura R, et al. Pylorus-preserving surgery based on the sentinel node concept in early gastric cancer. Ann Surg Oncol. 2016;23(13):4247–52.CrossRefPubMed
13.
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 N Am. 2000;80:1799–809.CrossRefPubMed
14.
Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.CrossRef
15.
Japanese Gastric Cancer Association. Japanese classification of gastric cancer (ed 14). Tokyo, Kanehara Publishing, 2010.
16.
Takeuchi H, Goto O, Yahagi M, Kitagawa Y. Function-preserving gastrectomy based on the sentinel node concept in early gastric cancer. Gastric Cancer. 2017;20(suppl 1):53–9.CrossRefPubMed
17.
Liebermann-Meffert DM, Meier R, Siewert JR. Vascular anatomy of the gastric tube used for esophageal reconstruction. Ann Thorac Surg. 1992;54(6):1110–5.CrossRefPubMed
18.
Goto O, Takeuchi H, Kawakubo H, Sasaki M, Matsuda T, Matsuda S, et al. First case of non-exposed endoscopic wall-inversion surgery with sentinel node basin dissection for early gastric cancer. Gastric Cancer. 2015;18:440–5.CrossRefPubMed
19.
Hiki N, Yamamoto Y, Fukunaga T, Yamaguchi T, Nunobe S, Tokunaga M, et al. Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection. Surg Endosc. 2008;22:1729–35.CrossRefPubMed
20.
Nunobe S, Hiki N, Gotoda T, Murao T, Haruma K, Matsumoto H, et al. Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer. Gastric Cancer. 2012;15:338–42.CrossRefPubMed
21.
Goto O, Mitsui T, Fujishiro M, Wada I, Shimizu N, Seto Y, et al. New method of endoscopic full-thickness resection: a pilot study of non-exposed endoscopic wall-inversion surgery in an ex vivo porcine model. Gastric Cancer. 2011;14:183–7.CrossRefPubMed
22.
Inoue H, Ikeda H, Hosoya T, Yoshida A, Onimaru M, Suzuki M, et al. Endoscopic mucosal resection, endoscopic submucosal dissection, and beyond: full-layer resection for gastric cancer with nonexposure technique (CLEAN-NET). Surg Oncol Clin N Am. 2012;21:129–40.CrossRefPubMed
Metadata
Title
Possibility of limited gastrectomy for early gastric cancer located in the upper third of the stomach, based on the distribution of sentinel node basins
Authors
Masaki Ohi
Yuji Toiyama
Yusuke Omura
Takashi Ichikawa
Hiromi Yasuda
Yoshinaga Okugawa
Hiroyuki Fujikawa
Yoshiki Okita
Shigeyuki Yoshiyama
Junichiro Hiro
Toshimitsu Araki
Masato Kusunoki
Publication date
01-06-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 6/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-1768-6

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