Assessment of lymph node micrometastasis in early gastric cancer in relation to sentinel nodes

Miyake, K; Seshimo, Akiyoshi; Kameoka, Shingo

doi:10.1007/s10120-006-0378-3

Cited by 36 publications

(23 citation statements)

References 24 publications

(37 reference statements)

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“…Five studies used 1 mL of isosulfan blue [21,22,[25][26][27]. Nine studies used 0.8-4 mL of patent blue [1,3,11,14,17,19,23,28,30]. Four studies used 2-5 mL of indocyanine green (ICG) [19,24,29,31].…”

Section: Results By Sln Identification Methodsmentioning

confidence: 99%

“…Four studies used 2-5 mL of indocyanine green (ICG) [19,24,29,31]. In eighteen studies, dye was endoscopically injected into the submucosa at 4 points adjacent to the tumor at laparotomy [1,3,11,14,17,[19][20][21][22][23][24][25][26][27][28][29][30][31]. SLNs were identified intraoperatively by direct visualisation of stained LNs.…”

Section: Results By Sln Identification Methodsmentioning

confidence: 99%

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What is the accuracy of sentinel lymph node biopsy for gastric cancer? A systematic review

et al. 2012

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Background In gastric cancer, the utility of sentinel lymph node (SLN) biopsy has not been established. SLN may be a good predictor of the pathological status of other lymph nodes and thus the necessity for more extensive surgery or lymph node dissection. We aimed to identify and synthesize findings on the performance of SLN biopsies in gastric cancer. Methods Electronic literature searches were conducted using Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from 1998 to 2009. Titles and abstracts were independently rated for relevance by a minimum of two reviewers. Techniques, detection rates, accuracy, sensitivity, specificity, and false-negative rates (FNRs) were analyzed. Analysis was performed based on the FNR. Results Twenty-six articles met our inclusion criteria. SLN detection using the dye method (DM) was reviewed in 18 studies, the radiocolloid method (RM) was used in 12 studies, and both dye and radiocolloid methods (DUAL) were used in 5 studies. The DM had an overall calculated FNR of 34.7% (95% confidence interval [CI] 21.2, 48.1). The RM had an overall calculated FNR of 18.5% (95% CI 9.1, 28.0). DUAL had an overall calculated FNR of 13.1% (95% CI -0.9, 27.2). Conclusion Application of the SLN technique may be practical for early gastric cancer. The use of DUAL for identifying SLN may yield a lower FNR than either method alone, although statistical significance was not met.

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Section: Results By Sln Identification Methodsmentioning

confidence: 99%

Section: Results By Sln Identification Methodsmentioning

confidence: 99%

What is the accuracy of sentinel lymph node biopsy for gastric cancer? A systematic review

et al. 2012

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“…In this sense, the falsenegative rates might not reach 0 % even if there are advancements in molecular biological methods in the future. But almost articles about micrometastasis in SN biopsy support the oncological safety of LBD [23,28,35]. LBD is a ''de facto standard'' technique until a complete intraoperative diagnostic system is established.…”

Section: Intraoperative Diagnosis Of Snsmentioning

confidence: 99%

A new stage of sentinel node navigation surgery in early gastric cancer

et al. 2014

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Sentinel node (SN) navigation surgery is expected to realize organ-and function-preserving surgery with SN mapping, and has been applied in operations for breast cancer and melanoma. But there has been no definite evidence for the SN concept in gastric cancer. A prospective multicenter trial to confirm the SN concept for gastric cancer conducted by the Japan Society of Sentinel Node Navigation Surgery reported that the SN detection rate, sensitivity of positive SNs, and accuracy of nodal status are 97.5 % (387/397), 93 % (53/57), and 99 % (383/ 387), respectively. A detailed analysis of the trial suggested that strictly the ''lymphatic basin concept'' rather than the ''SN concept'' was confirmed in early gastric cancer. The Japan Society of Sentinel Node Navigation Surgery started a new trial of function-preserving gastrectomy with lymphatic basin dissection (LBD) for early gastric cancer without metastasis in SNs on the basis of this promising outcome of the trial. It is supposed that LBD guarantees curability in SN navigation surgery for early gastric cancer. Full-thickness resection or endoscopic submucosal dissection in combination with laparoscopic LBD will soon be a new treatment option for early gastric cancer.

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“…Lymphatic system has an important role in spread of gastric cancer metastasis, as well as of lymph node micrometastasis, mainly in undifferentiated histological types, restricted to blue nodes and lymph nodes within the dye flow area of patent blue used in sentinel node navigation surgery for early gastric cancers 21 .…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of occult lymph node micrometastasis in gastric cancer: a histochemical and immunohistochemical study based on 1997 UICC TNM and 1998 JGCA classifications

Dell'Aquila

Lopasso

Falzoni

et al. 2008

ABCD, arq. bras. cir. dig.

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BACKGROUND: Micrometastasis is a single or a cluster of malignant cells inside the lymph node that are not detected by routine histopathological sections. Micrometastasis is related to poorer prognosis in many gastric cancer studies the real significance of these cells is still controversial. AIM: To evaluate if lymph node micrometastasis is a significant independent prognostic factor and important risk factor for recurrence in gastric cancer. METHODS: A total of 1290 lymph nodes from 28 patients with gastric cancer, since 1998 until 2003, treated by radical resection (D2 and modified D3 lymphadenectomies) were studied. Three sections per lymph node were stained by Hematoxilin-Eosin, histochemical (AB-PAS) and immunohistochemical (AE1-AE3) techniques. Kaplan-Meier's survival curves and Log-rank/Cox tests were used in order to compares lymph node micrometastasis positivity, depth (pT) and location of tumor in gastric wall, histologic type, lymphatic, vascular and perineural invasion, lymph node status (pN) and stage. RESULTS: There were worse prognosis and recurrence in patients with positive lymph node micrometastasis related to vascular and perineural invasions, advanced lymph node status and advanced stages. CONCLUSION: Lymph node micrometastasis seems to be a significant independent prognostic factor and important risk factor for recurrence in gastric cancer, in a context of radical D2 lymphadenectomy

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Assessment of lymph node micrometastasis in early gastric cancer in relation to sentinel nodes

Cited by 36 publications

References 24 publications

What is the accuracy of sentinel lymph node biopsy for gastric cancer? A systematic review

What is the accuracy of sentinel lymph node biopsy for gastric cancer? A systematic review

A new stage of sentinel node navigation surgery in early gastric cancer

Prognostic significance of occult lymph node micrometastasis in gastric cancer: a histochemical and immunohistochemical study based on 1997 UICC TNM and 1998 JGCA classifications

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