TY - JOUR
T1 - Pylorus-Preserving Surgery Based on the Sentinel Node Concept in Early Gastric Cancer
AU - Shimada, Ayako
AU - Takeuchi, Hiroya
AU - Ono, Taiki
AU - Kamiya, Satoshi
AU - Fukuda, Kazumasa
AU - Nakamura, Rieko
AU - Takahashi, Tsunehiro
AU - Wada, Norihito
AU - Kawakubo, Hirofumi
AU - Saikawa, Yoshiro
AU - Omori, Tai
AU - Nakahara, Tadaki
AU - Jinzaki, Masahiro
AU - Murakami, Koji
AU - Kitagawa, Yuko
N1 - Publisher Copyright:
© 2016, Society of Surgical Oncology.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - 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.
AB - 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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U2 - 10.1245/s10434-016-5358-1
DO - 10.1245/s10434-016-5358-1
M3 - Article
C2 - 27364500
AN - SCOPUS:84976470979
SN - 1068-9265
VL - 23
SP - 4247
EP - 4252
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 13
ER -
