Skip to main content
Top
Published in: Annals of Surgical Oncology 2/2013

01-02-2013 | Gastrointestinal Oncology

New Sentinel Node Mapping Technologies for Early Gastric Cancer

Authors: Hiroya Takeuchi, MD, PhD, Yuko Kitagawa, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 2/2013

Login to get access

Abstract

The sentinel node (SN) concept has revolutionized the surgical staging of both melanoma and breast cancer over the past two decades. The application of this concept can yield benefits for patients by preventing various complications related to unnecessary prophylactic regional lymph node dissection in patients with cancer-negative SNs. Clinical application of SN mapping in patients with early gastric cancer has been a controversial issue for years. However, a recent meta-analysis and a prospective multicenter trial of SN mapping for early gastric cancer have shown acceptable SN detection rates and accuracy of determination of lymph node status. For early stage gastric cancer such as cT1N0M0, for which a better prognosis can be achieved through conventional surgical approaches, the establishment of individualized, minimally invasive treatments that may retain the patients’ quality of life should be the next surgical challenge. Although there are many unresolved technical issues, laparoscopic SN biopsy with laparoscopic minimized gastrectomy or endoscopic mucosal resection/endoscopic submucosal dissection has the potential to achieve this goal.
Literature
1.
go back to reference Sano T, Hollowood K. Early gastric cancer: diagnosis and less invasive treatments. Scand J Surg. 2006;95:249–55.PubMed Sano T, Hollowood K. Early gastric cancer: diagnosis and less invasive treatments. Scand J Surg. 2006;95:249–55.PubMed
2.
go back to reference Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146–8.PubMed Kitano S, Iso Y, Moriyama M, et al. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146–8.PubMed
3.
go back to reference Adachi Y, Shiraishi N, Shiromizu A, et al. Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg. 2000;135:806–10.PubMedCrossRef Adachi Y, Shiraishi N, Shiromizu A, et al. Laparoscopy-assisted Billroth I gastrectomy compared with conventional open gastrectomy. Arch Surg. 2000;135:806–10.PubMedCrossRef
4.
go back to reference Shinohara T, Kanaya S, Taniguchi K, et al. Laparoscopic total gastrectomy with D2 lymph node dissection for gastric cancer. Arch Surg. 2009;144:1138–42.PubMedCrossRef Shinohara T, Kanaya S, Taniguchi K, et al. Laparoscopic total gastrectomy with D2 lymph node dissection for gastric cancer. Arch Surg. 2009;144:1138–42.PubMedCrossRef
5.
go back to reference Hur H, Jeon HM, Kim W. Laparoscopy-assisted distal gastrectomy with D2 lymphadenectomy for T2b advanced gastric cancers: three years’ experience. J Surg Oncol. 2008;98:515–9.PubMedCrossRef Hur H, Jeon HM, Kim W. Laparoscopy-assisted distal gastrectomy with D2 lymphadenectomy for T2b advanced gastric cancers: three years’ experience. J Surg Oncol. 2008;98:515–9.PubMedCrossRef
6.
go back to reference Kim YW, Baik YH, Yun YH, et al. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008;248:721–7.PubMedCrossRef Kim YW, Baik YH, Yun YH, et al. Improved quality of life outcomes after laparoscopy-assisted distal gastrectomy for early gastric cancer: results of a prospective randomized clinical trial. Ann Surg. 2008;248:721–7.PubMedCrossRef
7.
go back to reference Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127:392–9.PubMedCrossRef Morton DL, Wen DR, Wong JH, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127:392–9.PubMedCrossRef
8.
go back to reference Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–401.PubMedCrossRef Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–401.PubMedCrossRef
9.
go back to reference Bilchik AJ, Saha S, Wiese D, et al. Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial. J Clin Oncol. 2001;19:1128–36.PubMed Bilchik AJ, Saha S, Wiese D, et al. Molecular staging of early colon cancer on the basis of sentinel node analysis: a multicenter phase II trial. J Clin Oncol. 2001;19:1128–36.PubMed
10.
go back to reference Kitagawa Y, Fujii H, Mukai M, et al. The role of the sentinel lymph node in gastrointestinal cancer. Surg Clin N Am. 2000;80:1799–809.PubMedCrossRef Kitagawa Y, Fujii H, Mukai M, et al. The role of the sentinel lymph node in gastrointestinal cancer. Surg Clin N Am. 2000;80:1799–809.PubMedCrossRef
11.
go back to reference Kitagawa Y, Kitano S, Kubota T, et al. Minimally invasive surgery for gastric cancer—toward a confluence of two major streams: a review. Gastric Cancer. 2005;8:103–10.PubMedCrossRef Kitagawa Y, Kitano S, Kubota T, et al. Minimally invasive surgery for gastric cancer—toward a confluence of two major streams: a review. Gastric Cancer. 2005;8:103–10.PubMedCrossRef
12.
go back to reference Kitagawa Y, Fujii H, Kumai K, et al. Recent advances in sentinel node navigation for gastric cancer: a paradigm shift of surgical management. J Surg Oncol. 2005;90:147–52.PubMedCrossRef Kitagawa Y, Fujii H, Kumai K, et al. Recent advances in sentinel node navigation for gastric cancer: a paradigm shift of surgical management. J Surg Oncol. 2005;90:147–52.PubMedCrossRef
13.
go back to reference Kitagawa Y, Kitajima M. Diagnostic validity of radio-guided sentinel node mapping for gastric cancer: a review of current status and future direction. Surg Technol Int. 2006;15:32–6.PubMed Kitagawa Y, Kitajima M. Diagnostic validity of radio-guided sentinel node mapping for gastric cancer: a review of current status and future direction. Surg Technol Int. 2006;15:32–6.PubMed
14.
go back to reference Nakahara T, Kitagawa Y, Takeuchi H, et al. Preoperative lymphoscintigraphy for detection of sentinel lymph node in patients with gastric cancer: initial experience. Ann Surg Oncol. 2008;15:1447–53.PubMedCrossRef Nakahara T, Kitagawa Y, Takeuchi H, et al. Preoperative lymphoscintigraphy for detection of sentinel lymph node in patients with gastric cancer: initial experience. Ann Surg Oncol. 2008;15:1447–53.PubMedCrossRef
15.
go back to reference Vermeeren L, van der Ploeg IM, Olmos RA, et al. SPECT/CT for preoperative sentinel node localization. J Surg Oncol. 2010;101:184–90.PubMed Vermeeren L, van der Ploeg IM, Olmos RA, et al. SPECT/CT for preoperative sentinel node localization. J Surg Oncol. 2010;101:184–90.PubMed
16.
go back to reference Saikawa Y, Otani Y, Kitagawa Y, et al. Interim results of sentinel node biopsy during laparoscopic gastrectomy: possible role in function-preserving surgery for early cancer. World J Surg. 2006;30:1962–8.PubMedCrossRef Saikawa Y, Otani Y, Kitagawa Y, et al. Interim results of sentinel node biopsy during laparoscopic gastrectomy: possible role in function-preserving surgery for early cancer. World J Surg. 2006;30:1962–8.PubMedCrossRef
17.
go back to reference Takeuchi H, Saikawa Y, Kitagawa Y. Laparoscopic sentinel node navigation surgery for early gastric cancer. Asian J Endosc Surg. 2009;2:13–7.CrossRef Takeuchi H, Saikawa Y, Kitagawa Y. Laparoscopic sentinel node navigation surgery for early gastric cancer. Asian J Endosc Surg. 2009;2:13–7.CrossRef
18.
go back to reference Kitagawa Y, Saikawa Y, Takeuchi H, et al. Sentinel node navigation in early stage gastric cancer: updated data and current status. Scand J Surg. 2006;95:256–9.PubMed Kitagawa Y, Saikawa Y, Takeuchi H, et al. Sentinel node navigation in early stage gastric cancer: updated data and current status. Scand J Surg. 2006;95:256–9.PubMed
19.
go back to reference Takeuchi H, Oyama T, Kamiya S, et al. Laparoscopy-assisted proximal gastrectomy with sentinel node mapping for early gastric cancer. World J Surg. 2011;35:2463–71.PubMedCrossRef Takeuchi H, Oyama T, Kamiya S, et al. Laparoscopy-assisted proximal gastrectomy with sentinel node mapping for early gastric cancer. World J Surg. 2011;35:2463–71.PubMedCrossRef
20.
go back to reference Kinami S, Fujimura T, Ojima E, 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.PubMedCrossRef Kinami S, Fujimura T, Ojima E, 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.PubMedCrossRef
21.
go back to reference Hyung WJ, Kim YS, Lim JS, et al. Preoperative imaging of sentinel lymph nodes in gastric cancer using CT lymphography. Yonsei Med J. 2010;51:407–13.PubMedCrossRef Hyung WJ, Kim YS, Lim JS, et al. Preoperative imaging of sentinel lymph nodes in gastric cancer using CT lymphography. Yonsei Med J. 2010;51:407–13.PubMedCrossRef
22.
go back to reference Tsujimoto H, Yaguchi Y, Sakamoto N, et al. Computed tomography lymphography for the detection of sentinel nodes in patients with gastric carcinoma. Cancer Sci. 2010;101:2586–90.PubMedCrossRef Tsujimoto H, Yaguchi Y, Sakamoto N, et al. Computed tomography lymphography for the detection of sentinel nodes in patients with gastric carcinoma. Cancer Sci. 2010;101:2586–90.PubMedCrossRef
23.
go back to reference Hayashi T, Tangoku A, Suga K, et al. CT lymphography-navigated sentinel lymph node biopsy in patients with superficial esophageal cancer. Surgery. 2006;139:224–35.PubMedCrossRef Hayashi T, Tangoku A, Suga K, et al. CT lymphography-navigated sentinel lymph node biopsy in patients with superficial esophageal cancer. Surgery. 2006;139:224–35.PubMedCrossRef
24.
go back to reference Lim JS, Choi J, Song J, et al. Nanoscale iodized oil emulsion: a useful tracer for pretreatment sentinel node detection using CT lymphography in a normal canine gastric model. Surg Endosc. 2012;26:2267–74. PubMedCrossRef Lim JS, Choi J, Song J, et al. Nanoscale iodized oil emulsion: a useful tracer for pretreatment sentinel node detection using CT lymphography in a normal canine gastric model. Surg Endosc. 2012;26:2267–74. PubMedCrossRef
25.
go back to reference Hiraiwa K, Ueda M, Takeuchi H, et al. Sentinel node mapping with thermoresponsive magnetic nanoparticles in rats. J Surg Res. 2012;174:48–55.PubMedCrossRef Hiraiwa K, Ueda M, Takeuchi H, et al. Sentinel node mapping with thermoresponsive magnetic nanoparticles in rats. J Surg Res. 2012;174:48–55.PubMedCrossRef
26.
go back to reference Tajima Y, Murakami M, Yamazaki K, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging during laparoscopic surgery in gastric cancer. Ann Surg Oncol. 2010;17:1787–93.PubMedCrossRef Tajima Y, Murakami M, Yamazaki K, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging during laparoscopic surgery in gastric cancer. Ann Surg Oncol. 2010;17:1787–93.PubMedCrossRef
27.
go back to reference Ishikawa K, Yasuda K, Shiromizu T, Etoh T, Shiraishi N, Kitano S. Laparoscopic sentinel node navigation achieved by infrared ray electronic endoscopy system in patients with gastric cancer. Surg Endosc. 2007;21:1131–4.PubMedCrossRef Ishikawa K, Yasuda K, Shiromizu T, Etoh T, Shiraishi N, Kitano S. Laparoscopic sentinel node navigation achieved by infrared ray electronic endoscopy system in patients with gastric cancer. Surg Endosc. 2007;21:1131–4.PubMedCrossRef
28.
go back to reference Ohdaira H, Nimura H, Mitsumori N, Takahashi N, Kashiwagi H, Yanaga K. Validity of modified gastrectomy combined with sentinel node navigation surgery for early gastric cancer. Gastric Cancer. 2007;10:117–22.PubMedCrossRef Ohdaira H, Nimura H, Mitsumori N, Takahashi N, Kashiwagi H, Yanaga K. Validity of modified gastrectomy combined with sentinel node navigation surgery for early gastric cancer. Gastric Cancer. 2007;10:117–22.PubMedCrossRef
29.
go back to reference Nimura H, Narimiya N, Mitsumori N, et al. Infrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer. Br J Surg. 2004;91:575–9.PubMedCrossRef Nimura H, Narimiya N, Mitsumori N, et al. Infrared ray electronic endoscopy combined with indocyanine green injection for detection of sentinel nodes of patients with gastric cancer. Br J Surg. 2004;91:575–9.PubMedCrossRef
30.
go back to reference Miyashiro I, Miyoshi N, Hiratsuka M, et al. Detection of sentinel node in gastric cancer surgery by indocyanine green fluorescence imaging: comparison with infrared imaging. Ann Surg Oncol. 2008;15:1640–3.PubMedCrossRef Miyashiro I, Miyoshi N, Hiratsuka M, et al. Detection of sentinel node in gastric cancer surgery by indocyanine green fluorescence imaging: comparison with infrared imaging. Ann Surg Oncol. 2008;15:1640–3.PubMedCrossRef
31.
go back to reference Tajima Y, Yamazaki K, Masuda Y, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg. 2009;249:58–62.PubMedCrossRef Tajima Y, Yamazaki K, Masuda Y, et al. Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg. 2009;249:58–62.PubMedCrossRef
32.
go back to reference Wang Z, Dong ZY, Chen JQ, Liu JL. Diagnostic value of sentinel lymph node biopsy in gastric cancer: a meta-analysis. Ann Surg Oncol. 2012;19:1541–50.PubMedCrossRef Wang Z, Dong ZY, Chen JQ, Liu JL. Diagnostic value of sentinel lymph node biopsy in gastric cancer: a meta-analysis. Ann Surg Oncol. 2012;19:1541–50.PubMedCrossRef
33.
go back to reference Can MF, Yagci G, Cetiner S. Sentinel lymph node biopsy for gastric cancer: where do we stand? World J Gastrointest Surg. 2011;27:131–7.CrossRef Can MF, Yagci G, Cetiner S. Sentinel lymph node biopsy for gastric cancer: where do we stand? World J Gastrointest Surg. 2011;27:131–7.CrossRef
34.
go back to reference Kitagawa Y, Takeuchi H, Takagi Y, et al. Prospective multicenter trial of sentinel node mapping for gastric cancer. American Society of Clinical Oncology, 45th Annual Meeting (Abstract No. 4518), Orlando, FL; 2009. Kitagawa Y, Takeuchi H, Takagi Y, et al. Prospective multicenter trial of sentinel node mapping for gastric cancer. American Society of Clinical Oncology, 45th Annual Meeting (Abstract No. 4518), Orlando, FL; 2009.
35.
go back to reference 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;99:441–50.PubMedCrossRef 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;99:441–50.PubMedCrossRef
36.
go back to reference Yanagita S, Natsugoe S, Uenosono Y, et al. Detection of micrometastases in sentinel node navigation surgery for gastric cancer. Surg Oncol. 2008;17:203–10.PubMedCrossRef Yanagita S, Natsugoe S, Uenosono Y, et al. Detection of micrometastases in sentinel node navigation surgery for gastric cancer. Surg Oncol. 2008;17:203–10.PubMedCrossRef
37.
go back to reference Matsuda J, Kitagawa Y, Fujii H, et al. Significance of metastasis detected by molecular techniques in sentinel nodes of patients with gastrointestinal cancer. Ann Surg Oncol. 2004;11:250–4. Matsuda J, Kitagawa Y, Fujii H, et al. Significance of metastasis detected by molecular techniques in sentinel nodes of patients with gastrointestinal cancer. Ann Surg Oncol. 2004;11:250–4.
38.
go back to reference Xu X, Roberts SA, Pasha TL, Zhang PJ. Undesirable cytokeratin immunoreactivity of native nonepithelial cells in sentinel lymph nodes from patients with breast carcinoma. Arch Pathol Lab Med. 2000;124:1310–3.PubMed Xu X, Roberts SA, Pasha TL, Zhang PJ. Undesirable cytokeratin immunoreactivity of native nonepithelial cells in sentinel lymph nodes from patients with breast carcinoma. Arch Pathol Lab Med. 2000;124:1310–3.PubMed
39.
go back to reference Isozaki H, Okajima K, Fujii K. Histological evaluation of lymph node metastasis on serial sectioning in gastric cancer with radical lymphadenectomy. Hepatogastroenterology. 1997;44:1133–6.PubMed Isozaki H, Okajima K, Fujii K. Histological evaluation of lymph node metastasis on serial sectioning in gastric cancer with radical lymphadenectomy. Hepatogastroenterology. 1997;44:1133–6.PubMed
40.
go back to reference Morita D, Tsuda H, Ichikura T, et al. Analysis of sentinel node involvement in gastric cancer. Clin Gastroenterol Hepatol. 2007;5:1046–52.PubMedCrossRef Morita D, Tsuda H, Ichikura T, et al. Analysis of sentinel node involvement in gastric cancer. Clin Gastroenterol Hepatol. 2007;5:1046–52.PubMedCrossRef
41.
go back to reference Cochran AJ, Robert A, Wen DR, et al. Accurate evaluation of nodal tissues for the presence of tumor is central to the sentinel node approach. Selective sentinel lymphadenectomy for human solid cancer. In: Cancer treatment and research. New York: Springer; 2005. Cochran AJ, Robert A, Wen DR, et al. Accurate evaluation of nodal tissues for the presence of tumor is central to the sentinel node approach. Selective sentinel lymphadenectomy for human solid cancer. In: Cancer treatment and research. New York: Springer; 2005.
42.
go back to reference Pantel K, Cote RJ, Fodstad O. Detection and clinical importance of micrometastatic disease. J Natl Cancer Inst. 1999;91:1113–24.PubMedCrossRef Pantel K, Cote RJ, Fodstad O. Detection and clinical importance of micrometastatic disease. J Natl Cancer Inst. 1999;91:1113–24.PubMedCrossRef
43.
go back to reference Arigami T, Natsugoe S, Uenosono Y, et al. Evaluation of sentinel node concept in gastric cancer based on lymph node micrometastasis determined by reverse transcription–polymerase chain reaction. Ann Surg. 2006;243:341–7.PubMedCrossRef Arigami T, Natsugoe S, Uenosono Y, et al. Evaluation of sentinel node concept in gastric cancer based on lymph node micrometastasis determined by reverse transcription–polymerase chain reaction. Ann Surg. 2006;243:341–7.PubMedCrossRef
44.
go back to reference Shimizu Y, Takeuchi H, Sakakura Y, et al. Molecular detection of sentinel node micrometastases in patients with clinical N0 gastric carcinoma with real-time multiplex reverse transcription-polymerase chain reaction assay. Ann Surg Oncol. 2012;19:469–77.PubMedCrossRef Shimizu Y, Takeuchi H, Sakakura Y, et al. Molecular detection of sentinel node micrometastases in patients with clinical N0 gastric carcinoma with real-time multiplex reverse transcription-polymerase chain reaction assay. Ann Surg Oncol. 2012;19:469–77.PubMedCrossRef
45.
go back to reference Tsujimoto M, Nakabayashi K, Yoshidome K, et al. One-step nucleic acid amplification for intraoperative detection of lymph node metastasis in breast cancer patients. Clin Cancer Res. 2007;13:4807–16.PubMedCrossRef Tsujimoto M, Nakabayashi K, Yoshidome K, et al. One-step nucleic acid amplification for intraoperative detection of lymph node metastasis in breast cancer patients. Clin Cancer Res. 2007;13:4807–16.PubMedCrossRef
47.
go back to reference Ishigami S, Natsugoe S, Tokuda K, et al. Clinical impact of micrometastasis of the lymph node in gastric cancer. Am Surg. 2003;69:573–7.PubMed Ishigami S, Natsugoe S, Tokuda K, et al. Clinical impact of micrometastasis of the lymph node in gastric cancer. Am Surg. 2003;69:573–7.PubMed
48.
go back to reference Fukagawa T, Sasako M, Ito S, et al. The prognostic significance of isolated tumor cells in the lymph nodes of gastric cancer patients. Gastric Cancer. 2010;13:191–6.PubMedCrossRef Fukagawa T, Sasako M, Ito S, et al. The prognostic significance of isolated tumor cells in the lymph nodes of gastric cancer patients. Gastric Cancer. 2010;13:191–6.PubMedCrossRef
49.
go back to reference Yanagita S, Natsugoe S, Uenosono Y, et al. Sentinel node micrometastases have high proliferative potential in gastric cancer. J Surg Res. 2008;145:238–43.PubMedCrossRef Yanagita S, Natsugoe S, Uenosono Y, et al. Sentinel node micrometastases have high proliferative potential in gastric cancer. J Surg Res. 2008;145:238–43.PubMedCrossRef
50.
go back to reference Japanese Gastric Cancer Association. Gastric cancer treatment guidelines. 3rd edition. Tokyo: Kanehara Publishing; 2010. Japanese Gastric Cancer Association. Gastric cancer treatment guidelines. 3rd edition. Tokyo: Kanehara Publishing; 2010.
51.
go back to reference Kalloo AN, Singh VK, Jagannath SB, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7.PubMedCrossRef Kalloo AN, Singh VK, Jagannath SB, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc. 2004;60:114–7.PubMedCrossRef
52.
go back to reference Allori AC, Leitman IM, Heitman E. Natural orifice transluminal endoscopic surgery. Arch Surg. 2008;243:333–4.CrossRef Allori AC, Leitman IM, Heitman E. Natural orifice transluminal endoscopic surgery. Arch Surg. 2008;243:333–4.CrossRef
53.
go back to reference Cahill RA, Perretta S, Leroy J, Dallemagne B, Marescaux J. Lymphatic mapping and sentinel node biopsy in the colonic mesentery by natural orifice transluminal endoscopic surgery (NOTES). Ann Surg Oncol. 2008;15:2677–83.PubMedCrossRef Cahill RA, Perretta S, Leroy J, Dallemagne B, Marescaux J. Lymphatic mapping and sentinel node biopsy in the colonic mesentery by natural orifice transluminal endoscopic surgery (NOTES). Ann Surg Oncol. 2008;15:2677–83.PubMedCrossRef
54.
go back to reference Takeuchi H, Kitagawa Y. Sentinel node biopsy without scars. Does natural orifice transluminal endoscopic surgery herald a new era for early GI cancer? Ann Surg Oncol. 2008;15:2639–40.PubMedCrossRef Takeuchi H, Kitagawa Y. Sentinel node biopsy without scars. Does natural orifice transluminal endoscopic surgery herald a new era for early GI cancer? Ann Surg Oncol. 2008;15:2639–40.PubMedCrossRef
Metadata
Title
New Sentinel Node Mapping Technologies for Early Gastric Cancer
Authors
Hiroya Takeuchi, MD, PhD
Yuko Kitagawa, MD, PhD, FACS
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 2/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2602-1

Other articles of this Issue 2/2013

Annals of Surgical Oncology 2/2013 Go to the issue