Pylorus-Preserving Surgery Based on the Sentinel Node Concept in Early Gastric Cancer.

Abstract

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.

• Authors: Ayako Shimada, Hiroya Takeuchi, Taiki Ono, Satoshi Kamiya, Kazumasa Fukuda, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Hirofumi Kawakubo, Yoshiro Saikawa, Tai Omori, Tadaki Nakahara, Masahiro Jinzaki, Koji Murakami, Yuko Kitagawa
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 23 Issue 13 Pg. 4247-4252 (12 2016) ISSN: 1534-4681 [Electronic] United States
• PMID: 27364500 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Technetium Compounds
• Tin Compounds
• technetium Tc 99m tin colloid

Topics

• Aged
• Female
• Gastrectomy (methods)
• Humans
• Lymph Node Excision
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Staging
• Organ Sparing Treatments
• Patient Selection
• Pylorus (surgery)
• Radiopharmaceuticals
• Retrospective Studies
• Sentinel Lymph Node (diagnostic imaging, pathology, surgery)
• Stomach Neoplasms (pathology, surgery)
• Technetium Compounds
• Tin Compounds
• Tumor Burden