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Gastric Cancer
Published in: Gastric Cancer 4/2019

01-07-2019 | Gastrectomy | Original Article

Prospective feasibility study for single-tracer sentinel node mapping by ICG (indocyanine green) fluorescence and OSNA (one-step nucleic acid amplification) assay in laparoscopic gastric cancer surgery

Authors: Yoshiaki Shoji, Koshi Kumagai, Satoshi Kamiya, Satoshi Ida, Souya Nunobe, Manabu Ohashi, Shoichi Yoshimizu, Yusuke Horiuchi, Toshiyuki Yoshio, Akiyoshi Ishiyama, Toshiaki Hirasawa, Tomo Osako, Noriko Yamamoto, Junko Fujisaki, Takeshi Sano, Naoki Hiki

Published in: Gastric Cancer | Issue 4/2019

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Abstract

Background

The double-tracer method has been established for sentinel node (SN) mapping in gastric cancer surgery. However, there remain several unresolved issues that prevent its widespread use in clinical practice. In this study, we aimed to demonstrate the feasibility of single-tracer SN mapping in laparoscopic surgery for gastric cancer, using indocyanine green (ICG) fluorescence imaging with a one-step nucleic acid amplification (OSNA) assay intraoperatively.

Methods

Patients with clinical T1N0M0 gastric adenocarcinoma preoperatively were considered for inclusion if they had a single primary lesion 4 cm or less in maximal diameter. Immunohistochemical staining with the anti-cytokeratin 19 antibody was performed on preoperative biopsy specimens, and patients with faint positive reactions were excluded. Intraoperatively, single-tracer SN biopsy with ICG fluorescence imaging was performed, followed by laparoscopic gastrectomy with modified D1+ or D2 lymph node dissection.

Results

Twenty eligible patients underwent SN biopsy and laparoscopic gastrectomy. SNs were identified in 17 cases (85%), with a median number of three SNs per patient. The median times for SN mapping and OSNA assay were 19 and 35 min, respectively. OSNA assay detected one metastatic lymph node, but all other nodes were negative. No adverse effects were observed in relation to SN mapping.

Conclusions

Single-tracer SN mapping by ICG fluorescence imaging with intraoperative diagnosis by OSNA assay is feasible and safe. SNs can be identified in most patients, without producing false-negative results. Further clinical trial to demonstrate the sensitivity is ongoing.
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Metadata
Title
Prospective feasibility study for single-tracer sentinel node mapping by ICG (indocyanine green) fluorescence and OSNA (one-step nucleic acid amplification) assay in laparoscopic gastric cancer surgery
Authors
Yoshiaki Shoji
Koshi Kumagai
Satoshi Kamiya
Satoshi Ida
Souya Nunobe
Manabu Ohashi
Shoichi Yoshimizu
Yusuke Horiuchi
Toshiyuki Yoshio
Akiyoshi Ishiyama
Toshiaki Hirasawa
Tomo Osako
Noriko Yamamoto
Junko Fujisaki
Takeshi Sano
Naoki Hiki
Publication date
01-07-2019
Publisher
Springer Singapore
Published in
Gastric Cancer / Issue 4/2019
Print ISSN: 1436-3291
Electronic ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-018-00919-3

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