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Feasibility of sentinel node navigation surgery after noncurative endoscopic resection for early gastric cancer
Author(s) -
Arigami Takaaki,
Uenosono Yoshikazu,
Yanagita Shigehiro,
Matsushita Daisuke,
Arima Hideo,
Hirata Munetsugu,
Uchikado Yasuto,
Nakajo Akihiro,
Okumura Hiroshi,
Ishigami Sumiya,
Hokita Shuichi,
Natsugoe Shoji
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12269
Subject(s) - medicine , sentinel node , general surgery , surgery , cancer , endoscopic mucosal resection , endoscopy , cancer surgery , breast cancer
Background and Aim Recently, the use of additional surgery after noncurative endoscopic resection has gradually increased due to the rapid spread of endoscopic treatments in selected patients with early gastric cancer. Sentinel node navigation surgery ( SNNS ) has also been recognized as a minimally invasive surgery with personalized lymphadenectomy in early gastric cancer. Here, we assessed the feasibility of SNNS after noncurative endoscopic resection for early gastric cancer. Methods Sixteen patients with early gastric cancer, in whom additional surgery had been indicated due to noncurative endoscopic resection, were enrolled. They underwent a gastrectomy with standard lymphadenectomy. One day before surgery, 99m technetium‐tin colloid was endoscopically injected into the submucosa around the tumor. After surgery, the uptake of radioisotope in dissected lymph nodes was measured using Navigator GPS . Then, all dissected lymph nodes were investigated by hematoxylin‐eosin staining and immunohistochemistry using an antihuman cytokeratin monoclonal antibody. Results Hematoxylin‐eosin staining demonstrated lymph node metastasis in two (12.5%) of 16 patients and in three (0.8%) of 382 nodes. However, immunohistochemistry showed that none of the patients had lymph node micrometastasis. Sentinel nodes ( SN s) were identified in all patients. The mean number of SN s was 3.1 (range, 1–6). Among two patients with lymph node metastasis, the SN s, at least, contained positive nodes. Accordingly, the false‐negative and accuracy rates were 0% and 100%, respectively. Conclusion Our results indicate that SNNS may have potential as a further minimally invasive surgery in early gastric cancer patients after noncurative endoscopic resection.