PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow

Kinami, Shinichi; Fujimura, Takashi; Ojima, Eisuke; Fushida, Sachio; Ojima, Toshihiko; Funaki, Hiroshi; Fujita, Hideto; Takamura, Hiroyuki; Ninomiya, Itasu; Nishimura, Genichi; Kayahara, Masato; Ohta, Tetsuo; Zen, Yoh

doi:10.1007/s10147-007-0755-x

Cited by 81 publications

(92 citation statements)

References 24 publications

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Section: Retrieval Of Snsmentioning

confidence: 87%

“…But these nonstained or cold nodes with metastases existed in the lymphatic basin including stained nodes, except in one case [18,21]. This patient had an advanced cancer with a large number of metastatic nodes; M, Gre, type 3, 3 cm, pT2 (SS), pN1 (10/44) [21]. If metastases in stained or hot nodes cannot be detected by intraoperative biopsy in the case of the pick-up method, metastases in nonstained or cold nodes inside the lymphatic basin will be left.…”

Section: Retrieval Of Snsmentioning

confidence: 93%

“…Stained and/or hot nodes are retrieved on a back table just after the LBD and are submitted to intraoperative pathological examination. There are five lymphatic basins along the main arteries of the stomach: the left gastric artery, right gastric artery, left gastroepiploic artery, right gastroepiploic artery, and posterior gastric artery [21]. The type of surgery chosen depends on the tumor location and the number and location of the lymphatic basins.…”

Section: Retrieval Of Snsmentioning

confidence: 99%

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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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Section: Retrieval Of Snsmentioning

confidence: 87%

Section: Retrieval Of Snsmentioning

confidence: 93%

Section: Retrieval Of Snsmentioning

confidence: 99%

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

et al. 2014

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“…Several studies have proposed the concept of SN basin dissection [11,12]. The gastric lymphatic compartments are divided into five SN basins with the main gastric arteries as follows: left gastric artery (l-GA) basin, right gastric artery (r-GA) basin, right gastroepiploic artery (r-GEA) basin, left gastroepiploic artery (l-GEA) basin, and posterior gastric artery (p-GA) basin.…”

Section: Introductionmentioning

confidence: 99%

“…8a) are defined as the anterosuperior lymph nodes along the common hepatic artery [13]. According to Kinami et al [12], LN No. 8a are considered to belong to the r-GA basin.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of the anterosuperior lymph nodes along the common hepatic artery identified by sentinel node mapping in patients with gastric cancer

et al. 2015

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Background The sentinel node (SN) concept is safely applied and validated in early gastric cancer. Gastric lymph nodes are divided into five basins with the main gastric arteries, and the anterosuperior lymph nodes with the common hepatic artery (No. 8a) Methods Four hundred and twenty-nine patients with cT1N0 or cT2N0 gastric cancer underwent SN mapping. We used technetium-99 tin colloid solution and blue dye as a tracer. Results We detected SN No. 8a in 35 (8.2 %) patients. In these patients, we detected SN No. 8a with SNs that belonged to the left gastric artery (l-GA) basin (66 %), right gastroepiploic artery (r-GEA) basin (54 %), and right gastric artery (r-GA) basin (46 %). In addition, celiac artery lymph nodes were detected as SNs significantly more frequently. Function-preserving surgery was performed significantly less often in patients with SN No. 8a (p =0.018). Conclusions We found that SN No. 8a seemed to have lymphatic flow not only from the r-GA basin, but also from the l-GA basin or r-GEA basin. When SN No. 8a are detected, we should be careful to perform function-preserving surgery, even in SN-negative cases.

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Long‐term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema

Nguyen

Suami

Hanasono

et al. 2016

Journal of Surgical Oncology

130

116

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PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow

Abstract: The advantage of the PTD classification is that if the PTD classification were to be used as a guide for gastric resection procedures, preservation of the pylorus would become possible without diminishing the prognosis in patients with cT1N0 cancer located in zone T.

Cited by 81 publications

References 24 publications

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

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

Clinical significance of the anterosuperior lymph nodes along the common hepatic artery identified by sentinel node mapping in patients with gastric cancer

Long‐term outcomes of the minimally invasive free vascularized omental lymphatic flap for the treatment of lymphedema

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