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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2016

01-12-2016 | Gastrointestinal Oncology

Pylorus-Preserving Surgery Based on the Sentinel Node Concept in Early Gastric Cancer

Authors: Ayako Shimada, MD, Hiroya Takeuchi, MD, PhD, Taiki Ono, MD, Satoshi Kamiya, MD, Kazumasa Fukuda, PhD, Rieko Nakamura, MD, PhD, Tsunehiro Takahashi, MD, PhD, Norihito Wada, MD, PhD, Hirofumi Kawakubo, MD, PhD, Yoshiro Saikawa, MD, PhD, Tai Omori, MD, Tadaki Nakahara, MD, PhD, Masahiro Jinzaki, MD, PhD, Koji Murakami, MD, PhD, Yuko Kitagawa, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2016

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Abstract

Background

In patients with early stage gastric cancer in the middle third of the stomach, pylorus-preserving gastrectomy (PPG) can be an option as function-preserving surgery, although its oncologic safety is not definitively defined. This issues may be overcome using the sentinel node (SN) concept. The aim of this study was to investigate the effectiveness of the SN concept in early gastric cancer patients who are candidates for PPG.

Methods

One hundred fifty-six patients with middle-third location of cT1N0 gastric cancer (single lesion, <4 cm) underwent distal gastrectomy with SN mapping. As a tracer, technetium-99 tin colloid solution and blue dye were endoscopically injected into the submucosal layer surrounding the primary tumor.

Results

SN detection rate was 100 % (156 of 156), and the accuracy of the nodal evaluation of metastasis was 99 % (155 of 156). Suprapyloric lymph node (LN; LN No. 5) and infrapyloric LN (LN No. 6) were detected as SNs in 6 and 14 % of the patients, respectively. We also found two cases with metastasis to LN No. 5 or LN No. 6.

Discussion

When performing PPG, the possibility of LN metastasis, especially to LN No. 5 and LN No. 6, cannot be underestimated. SN mapping can play an important role to predict the possibility of metastasis to LN No. 5 and LN No. 6.
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Metadata
Title
Pylorus-Preserving Surgery Based on the Sentinel Node Concept in Early Gastric Cancer
Authors
Ayako Shimada, MD
Hiroya Takeuchi, MD, PhD
Taiki Ono, MD
Satoshi Kamiya, MD
Kazumasa Fukuda, PhD
Rieko Nakamura, MD, PhD
Tsunehiro Takahashi, MD, PhD
Norihito Wada, MD, PhD
Hirofumi Kawakubo, MD, PhD
Yoshiro Saikawa, MD, PhD
Tai Omori, MD
Tadaki Nakahara, MD, PhD
Masahiro Jinzaki, MD, PhD
Koji Murakami, MD, PhD
Yuko Kitagawa, MD, PhD
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5358-1

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