Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2014

01-09-2014 | Gastrointestinal Oncology

Suitability of Sentinel Node Mapping as an Index of Metastasis in Early Gastric Cancer Following Endoscopic Resection

Authors: Shuhei Mayanagi, MD, Hiroya Takeuchi, MD, PhD, Satoshi Kamiya, MD, Masahiro Niihara, MD, 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, Makio Mukai, MD, PhD, Yuko Kitagawa, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2014

Login to get access

Abstract

Background

When pathological diagnosis following endoscopic resection (ER) for early gastric cancer (EGC) suggests probable lymph node metastasis, additional surgery with lymphadenectomy should be performed. The sentinel node (SN) concept has yet to be applied to tumors following ER. The aim of this study was to evaluate the feasibility of SN navigation surgery for such tumors.

Methods

Forty patients diagnosed with EGC lesions <4 cm in diameter underwent gastrectomy with SN mapping following ER. A technetium-99 m tin colloid solution and a dye were injected into the submucosal layer around the post-ER scar in all four abdominal quadrants. We then compared the SN distribution and metastases among the patients who underwent ER and controls (n = 192).

Results

SNs were identifiable in all patients, and the mean number of SNs per case was 4.9. The location of the SN basin was similar in the patients who underwent ER and the controls. One patient (3 %) whose primary tumor had invaded the submucosal layer had a metastatic SN. The median time from ER to surgery was 73 days. No postoperative recurrence was observed in any patient over a median follow-up of 1,023 days.

Conclusions

Our findings suggest that the SN basin is not greatly affected by ER. The SN concept could be suitable for tumors following ER, but conventional gastrectomy with lymphadenectomy involving the SN basin should be used at present.
Literature
1.
2.
3.
Murakami T. Pathomorphological diagnosis: definition and gross classification of early gastric cancer. Gann Monogr Cancer Res. 1971;11:53–5.
4.
Japanese Gastric Cancer Association Registration Committee, Maruyama K, Kaminishi M, et al. Gastric cancer treated in 1991 in Japan: data analysis of nationwide registry. Gastric Cancer. 2006;9:51–66.PubMedCrossRef
5.
Gotoda T, Yanagisawa A, Sasako M, et al. Incidence of lymph node metastasis from early gastric cancer: estimation with a large number of cases at two large centers. Gastric Cancer. 2000;3:219–25.PubMedCrossRef
6.
7.
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.
Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–8. discussion 398–401.PubMedCentralPubMedCrossRef
9.
Kitagawa Y, Fujii H, Mukai M, et al. Radio-guided sentinel node detection for gastric cancer. Br J Surg. 2002;89:604–8.PubMedCrossRef
10.
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
11.
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
12.
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
13.
Kitagawa Y, Takeuchi H, Takagi Y, et al. Sentinel node mapping for gastric cancer: a prospective multicenter trial in Japan. J Clin Oncol. 2013;31:3704–10.PubMedCrossRef
14.
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
15.
Takeuchi H, Kitagawa Y. New sentinel node mapping technologies for early gastric cancer. Ann Surg Oncol. 2013;20:522–32.PubMedCrossRef
16.
Tada M, Karita M, Yanai H, Takemoto T. Endoscopic therapy of early gastric cancer by strip biopsy. Gan To Kagaku Ryoho. 1988;15:1460–5.PubMed
17.
Gotoda T, Yamamoto H, Soetikno RM. Endoscopic submucosal dissection of early gastric cancer. J Gastroenterol. 2006;41:929–42.PubMedCrossRef
18.
19.
Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.
20.
Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101–12.CrossRef
21.
Japanese Gastric Cancer Assocation. Japanese Classification of Gastric Carcinoma: 2nd English edition. Gastric Cancer. 1998;1:10–24.CrossRef
22.
UCC. TNM classification of malignant tumours. Weinheim: Wiley; 2009.
23.
Hirao M, Masuda K, Asanuma T, et al. Endoscopic resection of early gastric cancer and other tumors with local injection of hypertonic saline-epinephrine. Gastrointest Endosc. 1988;34:264–9.PubMedCrossRef
24.
Tada M, Murakami A, Karita M, et al. Endoscopic resection of early gastric cancer. Endoscopy. 1993;25:445–50.PubMedCrossRef
25.
Inoue H, Takeshita K, Hori H, et al. Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions. Gastrointest Endosc. 1993;39:58–62.PubMedCrossRef
26.
Yamamoto H, Yube T, Isoda N, et al. A novel method of endoscopic mucosal resection using sodium hyaluronate. Gastrointest Endosc. 1999;50:251–6.PubMedCrossRef
27.
Fujishiro M, Yahagi N, Kashimura K, et al. Comparison of various submucosal injection solutions for maintaining mucosal elevation during endoscopic mucosal resection. Endoscopy. 2004;36:579–83.PubMedCrossRef
28.
Ono H, Hasuike N, Inui T, et al. Usefulness of a novel electrosurgical knife, the insulation-tipped diathermic knife-2, for endoscopic submucosal dissection of early gastric cancer. Gastric Cancer. 2008;11:47–52.PubMedCrossRef
29.
Takeuchi H, Fujii H, Ando N, et al. Validation study of radio-guided sentinel lymph node navigation in esophageal cancer. Ann Surg. 2009;249:757–63.PubMedCrossRef
30.
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
31.
Yasuda K, Shiraishi N, Suematsu T, et al. Rate of detection of lymph node metastasis is correlated with the depth of submucosal invasion in early stage gastric carcinoma. Cancer. 1999;85:2119–23.PubMedCrossRef
32.
Morita S, Katai H, Saka M, et al. Outcome of pylorus-preserving gastrectomy for early gastric cancer. Br J Surg. 2008;95:1131–5.PubMedCrossRef
33.
Nunobe S, Sasako M, Saka M, et al. Symptom evaluation of long-term postoperative outcomes after pylorus-preserving gastrectomy for early gastric cancer. Gastric Cancer. 2007;10:167–72.PubMedCrossRef
34.
Ichikawa D, Ueshima Y, Shirono K, et al. Esophagogastrostomy reconstruction after limited proximal gastrectomy. Hepatogastroenterology. 2001;48:1797–801.PubMed
Metadata
Title
Suitability of Sentinel Node Mapping as an Index of Metastasis in Early Gastric Cancer Following Endoscopic Resection
Authors
Shuhei Mayanagi, MD
Hiroya Takeuchi, MD, PhD
Satoshi Kamiya, MD
Masahiro Niihara, MD
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
Makio Mukai, MD, PhD
Yuko Kitagawa, MD, PhD
Publication date
01-09-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 9/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3662-1

Other articles of this Issue 9/2014

Annals of Surgical Oncology 9/2014 Go to the issue

Healthcare Policy and Outcomes

Cost of Contralateral Prophylactic Mastectomy

Colorectal Cancer

A Retrospective Review of 126 High-Grade Neuroendocrine Carcinomas of the Colon and Rectum

Breast Oncology

Impact of Bilateral Versus Unilateral Mastectomy on Short Term Outcomes and Adjuvant Therapy, 2003–2010: A Report from the National Cancer Data Base

Pancreatic Tumors

Reply to ‘Letter to the Editor of Annals of Surgical Oncology Concerning “Robotic versus Open Pancreatectomy: A Systematic Review and Meta-Analysis”,’ by Petrucciani Niccolò, et al. (ASO-2013-09-1427)

Hepatobiliary Tumors

γ-Glutamyltranspeptidase is a Prognostic Marker of Survival and Recurrence in Radiofrequency-Ablation Treatment of Hepatocellular Carcinoma

Thoracic Oncology

Optimizing Surrogate End Points for Preoperative Systemic Therapies in Non-Small Cell Lung Cancers